Clinical and imaging assessment of cognitive dysfunction in multiple sclerosis
Abstract
In patients with multiple sclerosis (MS), grey matter damage is widespread and might underlie many of the clinical symptoms, especially cognitive impairment. This relation between grey matter damage and cognitive impairment has been lent support by findings from clinical and MRI studies. However, many aspects of cognitive impairment in patients with MS still need to be characterised. Standardised neuropsychological tests that are easy to administer and sensitive to disease-related abnormalities are needed to gain a better understanding of the factors affecting cognitive performance in patients with MS than exists at present. Imaging measures of the grey matter are necessary, but not sufficient to fully characterise cognitive decline in MS. Imaging measures of both lesioned and normal-appearing white matter lend support to the hypothesis of the existence of an underlying disconnection syndrome that causes clinical symptoms to trigger. Findings on cortical reorganisation support the contribution of brain plasticity and cognitive reserve in limiting cognitive deficits. The development of clinical and imaging biomarkers that can monitor disease development and treatment response is crucial to allow early identification of patients with MS who are at risk of cognitive impairment.
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A quarter of MS patients suffer symptoms arising from neuronal dysfunction, such as episodic memory impairment, already at the first clinical episode.
“Despite a quarter of MS patients suffer symptoms arising from neuronal dysfunction, such as episodic memory impairment, already at the first clinical episode and show hippocampal microstructural damage [57, 63] we still lack a full understanding of how synaptic alterations start and how they are linked to microglia activation.”
From Glia-to-neuron transfer of miRNAs via extracellular vesicles: a new mechanism underlying inflammation-induced synaptic alterations (2018) · cites this paper as [63]
MS patients show hippocampal microstructural damage.
“Despite a quarter of MS patients suffer symptoms arising from neuronal dysfunction, such as episodic memory impairment, already at the first clinical episode and show hippocampal microstructural damage [57, 63] we still lack a full understanding of how synaptic alterations start and how they are linked to microglia activation.”
From Glia-to-neuron transfer of miRNAs via extracellular vesicles: a new mechanism underlying inflammation-induced synaptic alterations (2018) · cites this paper as [63]
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Age and disability drive cognitive impairment in multiple sclerosis across disease subtypes
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- Authors
- Rocca, M. A., Amato, M. P., De Stefano, N., Enzinger, C., Geurts, J. J., Penner, I.-K., Rovira, A., Sumowski, J. F., Valsasina, P., & Filippi, M.
- Venue
- The Lancet Neurology
- Publisher
- Elsevier BV
- Published
- 2015-03
- Volume
- 14
- Issue
- 3
- Pages
- 302-317
- ISSN
- 1474-4422
- Cited by
- 502
- References
- 5
- Language
- en
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