Cognitive impairment is common in MS and adds significantly to the burden of the disease. The ability to predict future cognitive impairment from imaging obtained at disease onset has not been investigated. An English study on the matter has been published in the Journal of Neurology, Neurosurgery, and Psychiatry.

Sixty-two patients imaged within 3 months of a clinically isolated syndrome were assessed neuropsychologically 7 years later. Baseline and periodic MRI measures of lesions, atrophy and normal-appearing white and grey matter were regressed against neuropsychological scores to explore the best predictors of cognitive outcome. Investigators found that 28 patients had developed clinically definite MS at follow-up and a further nine met revised McDonald criteria for MS. Deficits in speed of information processing and executive function were the most common abnormalities. Not unexpectedly, poor performance correlated with high anxiety ratings. Baseline T1 lesion metrics predicted executive deficits, and new T2 lesions at the 3-month follow-up predicted slowed information processing. An increase in myo-inositol concentration in normal-appearing white matter over the first 3 years was associated with poor executive function.

Based on their findings, the authors concluded that MRI variables obtained at the onset of a clinically isolated syndrome could predict future development of cognitive abnormalities. These results may have implications in monitoring and treating patients.

(Available from: http://www.pubmed.gov PMID: 18339729)

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