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Association of cognitive impairment with spinal cord MRI measures in radiologically isolated syndrome
Author(s): ,
J. Oh
Affiliations:
Division of Neurology, Department of Medicine, St. Michael`s Hospital, University of Toronto, Toronto, ON, Canada; Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
,
M. Guenette
Affiliations:
Division of Neurology, Department of Medicine, St. Michael`s Hospital, University of Toronto, Toronto, ON, Canada
,
E. Donaldson
Affiliations:
Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
,
E. Seyman
Affiliations:
Division of Neurology, Department of Medicine, St. Michael`s Hospital, University of Toronto, Toronto, ON, Canada
,
B. Dewey
Affiliations:
Department of Electrical and Computer Engineering, Johns Hopkins University; Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States
A. Feinstein
Affiliations:
Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
ECTRIMS Online Library. Oh J. Oct 12, 2018; 229002
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Abstract: P1162

Type: Poster Sessions

Abstract Category: Pathology and pathogenesis of MS - Neuropsychology

Introduction: Radiologically isolated syndrome (RIS) describes asymptomatic individuals with incidental MRI abnormalities suggestive of multiple sclerosis (MS). A significant portion of RIS develop MS over time and the presence of a spinal cord (SC) lesion has been identified as a risk factor that substantially increases the risk of developing MS. Cognitive impairment (CI) has been previously described in RIS, but the relationship between CI and SC-MRI measures has not yet been explored.
Objectives: To evaluate relationships between CI and MRI measures in the SC and brain of RIS.
Methods: 32 RIS subjects underwent 3T brain and cervical SC-MRI and cognitive assessment using the minimal assessment of cognitive function in MS (MACFIMS) battery. Multi-Atlas CRUISE performed brain segmentation yielding measures of whole-brain atrophy [brain parenchymal fraction (BPF)], thalamic volume, and cortical thickness. Quantitative cervical SC-MRI measures, including SC-cross-sectional area, diffusion-tensor and magnetization-transfer imaging metrics, and SC lesions were evaluated. Spearman's correlation coefficient (rho) and multivariable linear regression assessed relationships between CI and brain/SC MRI measures.
Results: Global CI was present in 47% (n=15) of RIS subjects. Amongst SC and brain MRI measures, SC-lesion count and BPF demonstrated the strongest univariate correlations with individual cognitive tests (rho = -0.50 with symbol digit modality test [SDMT] and SC-lesion count, p< 0.01; rho=0.52 with California verbal learning test [CVLT-II] and BPF, p< 0.01). In multivariable models of individual cognitive tests including age, sex, SC-lesion count, and BPF, SC-lesion count contributed to the variance of the CVLT-II (p=0.02), SDMT (p=0.09), and the paced auditory serial addition test (PASAT, p=0.05), independent of BPF. In these models, BPF contributed to CVLT-II and PASAT (p=0.008, p=0.07, respectively) but not SDMT (p=0.82).
Conclusion: CI is common in RIS and demonstrates significant relationships with SC-lesion count, independent of brain atrophy. Given that SC-lesions are a known risk factor for RIS conversion to MS, our findings suggest that CI may be a useful prognostic factor in RIS. Prospective follow-up of this cohort is planned, which will provide insight into the evolution of CI in RIS, its relationship to SC-MRI measures, and predictive value in the clinical management of RIS.
Disclosure: Dr. Jiwon Oh has received research grant funding from the MS Society of Canada, National MS Society, Brain Canada, Biogen-Idec, and Sanofi-Genzyme. Dr. Oh has also received personal compensation for consulting or speaking from EMD-Serono, Sanofi-Genzyme, Biogen-Idec, Novartis, and Roche.
Melanie Guenette has nothing to disclose.
Dr. Estelle Seyman has received fellowship funding through an educational grant from Novartis
Dr. Emily Donaldson has nothing to disclose.
Blake Dewey has nothing to disclose.
Dr. Anthony Feinstein has received speakers honoraria from Sanofi-Genzyme, Roche, Merck-Serono.

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