This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objectives: Evaluate cross-sectionally the contribution of focal cortical lesion (CL) subtypes at ultra-high-field MRI and traditional MRI metrics of brain damage to neurologic disability and cognitive performance in a heterogeneous multiple sclerosis (MS) cohort.
Methods: Thirty-four patients with early or established disease including clinically isolated syndrome, relapsing-remitting MS, and secondary progressive MS were scanned on a human 7-tesla (7T) (Siemens) scanner to acquire fast low-angle shot (FLASH) T2*-weighted images for characterization of white matter and deep gray matter lesion volume, and CL types. Patients also underwent anatomical 3T MRI for cortical thickness estimation, and neuropsychological testing within 1 week of the 7T scan. Twenty-seven patient scans were acceptable for further analysis. Neurologic disability was measured using the Expanded Disability Status Scale.
Results: Type III-IV CLs had the strongest relationship to physical disability (ρ = 0.670, p < 0.0001). White matter lesion volume and type I CLs are each significantly associated with 6 of 11 neuropsychological test variables. Type III-IV CLs significantly correlate with 4 of 11 neuropsychological test variables whereas type II CLs, deep gray matter lesion volume, and cortical thickness metrics are less frequently associated with cognitive performance.
Conclusions: Leukocortical (type I) and subpial (III-IV) CLs identified on 7T FLASH-T2* sequences are potential cortical biomarkers of cognitive and neurologic status in MS.
GLOSSARY
- ANT=
- Animal Naming Test;
- BDI=
- Beck Depression Inventory, 2nd edition;
- BVMTR=
- Brief Visual Memory Test–Revised;
- CL=
- cortical lesion;
- CLR=
- cortical lesion ratio;
- COWAT=
- Controlled Oral Word Association Test;
- CT=
- cortical thickness;
- CVLT2=
- California Verbal Learning Test, 2nd edition;
- DGMLV=
- deep gray matter lesion volume;
- DIR=
- double inversion recovery;
- EDSS=
- Expanded Disability Status Scale;
- FLASH=
- fast low-angle shot;
- GM=
- gray matter;
- JLOT=
- Judgment of Line Orientation Test;
- MEMPR=
- magnetization-prepared rapid acquisition with multiple gradient echoes;
- MS=
- multiple sclerosis;
- NPT=
- neuropsychological test;
- SDMT=
- Symbol Digit Modalities Test;
- SPMS=
- secondary progressive multiple sclerosis;
- WCST=
- Wisconsin Card Sorting Test–64 card deck;
- WM=
- white matter;
- WMLV=
- white matter lesion volume;
- WTAR=
- Wechsler Test of Adult Reading
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at www.neurology.org
- Received October 3, 2012.
- Accepted in final form April 29, 2013.
- © 2013 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
