The relationship between quantitative magnetic resonance imaging markers  and clinical/cognitive assessments in patients with multiple sclerosis:  A cross-sectional study

Habib  Farahmand; Amir  Moghadam-Ahmadi; Parvin  Khalili; Houshang  Amiri; Alireza  Vakilian; Fariba  Khatami; Seyed Hamid  Pakzad-Moghadam; Fatemeh  Ayoobi

doi:10.18502/cjn.v24i2.20691

Habib Farahmand Department of Radiology, Ali Ibn Abitaleb Educational and Treatment Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
Amir Moghadam-Ahmadi Neurological Diseases Section (NDS), Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD, USA
Parvin Khalili Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
Houshang Amiri Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
Alireza Vakilian Neurology Department, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
Fariba Khatami Department of Pathology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
Seyed Hamid Pakzad-Moghadam Department of Anaesthesiology, School of Medicine, Ali Ibn Abitaleb Educational and Treatment Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
Fatemeh Ayoobi Occupational Safety and Health Research Center, NICICO, World Safety Organization and Rafsanjan University of Medical Sciences, Rafsanjan, Iran

DOI: https://doi.org/10.18502/cjn.v24i2.20691

Keywords: Disability; Multiple Sclerosis; Cognitive Assessment; Quantitative Magnetic Resonance Imaging Markers; Plaque Location

Abstract

Background: This study examines the relationship between quantitative magnetic resonance imaging (MRI) markers and clinical/cognitive performance in patients with multiple sclerosis (MS), exploring the impact of MRI markers on disability, clinical status, and cognitive function.

Methods: This cross-sectional study recruited patients with MS from the MS registry center of Rafsanjan University of Medical Sciences, Rafsanjan, Iran. Informed consent was obtained from all participants
(8 men, 57 women). Patients with MS underwent neuropsychological and clinical assessments using a word-pair learning task, the Wisconsin Card Sorting test (WCST), Tower of London test (TOL), Paced Auditory Serial Addition Test (PASAT), Multiple Sclerosis Functional Composite (MSFC), and the Expanded Disability Status Scale (EDSS). MRI markers were assessed by the neurologist and radiologist. Statistical significance was set at P < 0.05.

Results: Patients with plaques in the basal ganglia and thalamus had significantly different MSFC (P = 0.038) and PASAT (P = 0.010) scores, while higher EDSS scores correlated with T2-weighted-fluid-attenuated inversion recovery (T2-FLAIR) hyper-intense plaques (P = 0.025). T1 black hole plaques were associated with increased depression (P = 0.015). WCST scores were significantly higher in patients with infratentorial plaques (P = 0.006) and those with T1 black hole lesions (P < 0.05). Total plaque volume positively correlated with EDSS score (r = 0.386, P = 0.002) and word-pair learning (r = 0.254, P = 0.045), and negatively correlated with PASAT scores (r = -0.299, P = 0.017). Enhanced plaques correlated positively with TOL performance (r = 0.319, P = 0.010).

Conclusion: Memory decline and increased disability in patients with MS are associated with brain volume loss, increased plaque volume, and plaque location in the infratentorial region, basal ganglia, and thalamus. Enhanced plaques or T1 black hole lesions also contribute to cognitive impairment.