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Cognitive dysfunction in patients with clinically isolated syndromes or newly diagnosed multiple sclerosis

Department of Neurology, Brigam and Women's Hospital, Harvard Medical School, Boston, MA, USA, bglanz{at}partners.org

CM Holland

Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA

SA Gauthier

Department of Neurology, Brigam and Women's Hospital, Harvard Medical School, Boston, MA, USA

EL Amunwa

Department of Neurology, Brigam and Women's Hospital, Harvard Medical School, Boston, MA, USA

Z. Liptak

Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA

MK Houtchens

Department of Neurology, Brigam and Women's Hospital, Harvard Medical School, Boston, MA, USA

RA Sperling

Department of Neurology, Brigam and Women's Hospital, Harvard Medical School, Boston, MA, USA

SJ Khoury

Department of Neurology, Brigam and Women's Hospital, Harvard Medical School, Boston, MA, USA

CRG Guttmann

Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA

HL Weiner

Department of Neurology, Brigam and Women's Hospital, Harvard Medical School, Boston, MA, USA

Cognitive dysfunction is common in patients with multiple sclerosis (MS), and has been associated with MRI measures of lesion burden and atrophy. Little is known about the prevalence of cognitive impairment in patients with early MS. The associations between cognitive impairment and MRI measures of disease severity early in the disease course are also unclear. This study used a brief battery of cognitive tests to determine the prevalence and pattern of cognitive impairment in patients with clinically isolated syndromes or newly diagnosed MS. The associations between cognitive impairment and MRI measures of disease severity early in the disease course were also examined. Ninety-two patients with clinically isolated syndromes or the diagnosis of MS within the last 3 years participating in the CLIMB study underwent a neurologic examination, neuropsychological evaluation and MRI at 1.5T. Forty-nine percent of patients were impaired on one or more cognitive measures. There were no significant correlations between cognitive scores and MRI measures of disease severity including total T2 lesion volume, normal appearing white matter volume, grey matter volume, and brain parenchymal fraction. These findings suggest that cognitive impairment may predate the appearance of gross structural abnormalities on MRI and serve as an early marker of disease activity in MS. Multiple Sclerosis 2007; 13: 1004—1010. http://msj.sagepub.com

Key Words: clinically isolated syndrome • cognition disorder • magnetic resonance imaging • multiple sclerosis

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