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Posterior brain damage and cognitive impairment in pediatric multiple sclerosis
- Source :
- Neurology. 82(15)
- Publication Year :
- 2014
-
Abstract
- Objective: We combined structural and functional MRI to better understand the mechanisms responsible for cognitive impairment in pediatric patients with multiple sclerosis (MS). Methods: Brain dual-echo, diffusion tensor, 3D T1-weighted, and resting-state (RS) fMRI scans were acquired from 35 consecutive pediatric patients with MS and 16 sex- and age-matched healthy controls. Patients with abnormalities in ≥2 neuropsychological tests were classified as cognitively impaired. The regional distribution of white matter (WM) and gray matter (GM) damage was assessed using voxel-wise analyses. Default mode network (DMN) RS functional connectivity (FC) was also measured. Results: Sixteen patients (45%) were classified as cognitively impaired. Compared to cognitively preserved (CP) patients, cognitively impaired patients with MS had higher occurrence of T2 lesions as well as more severe damage to the WM and GM, as measured by atrophy and diffusivity abnormalities, in the posterior regions of the parietal lobes close to the midline (precuneus, posterior cingulum, and corpus callosum). Compared to the other study groups, they also showed reduced RS FC of the precuneus, whereas CP patients experienced an increased RS FC of the anterior cingulate cortex. A multivariable model identified diffusivity abnormalities of the cingulum and corpus callosum and RS FC of the precuneus as the covariates more strongly associated with cognitive impairment (C-index = 0.99). Conclusions: In pediatric patients with MS, cognitive dysfunction is associated with structural and functional abnormalities of the posterior core regions of the DMN. WM structural abnormalities co-occurring at this level are likely to be the substrate of such modifications.
- Subjects :
- Male
medicine.medical_specialty
Multiple Sclerosis
Adolescent
Precuneus
Neuroimaging
Neuropsychological Tests
Corpus callosum
Brain mapping
Nerve Fibers, Myelinated
White matter
Nerve Fibers
Settore MED/39 - NEUROPSICHIATRIA INFANTILE
Internal medicine
medicine
Humans
Child
Default mode network
Anterior cingulate cortex
Brain Mapping
business.industry
Multiple sclerosis
Neuropsychology
Brain
medicine.disease
Magnetic Resonance Imaging
Settore MED/37 - NEURORADIOLOGIA
Settore MED/26 - NEUROLOGIA
medicine.anatomical_structure
Cardiology
Myelinated
Female
Neurology (clinical)
Atrophy
business
Cognition Disorders
Subjects
Details
- ISSN :
- 1526632X
- Volume :
- 82
- Issue :
- 15
- Database :
- OpenAIRE
- Journal :
- Neurology
- Accession number :
- edsair.doi.dedup.....97904e2d1447cbc88ab64620727ab086