Posterior brain damage and cognitive impairment in paediatric MS


Research into MS and quality of life:
The researchers in this study used both structural and functional MRI to get a better understanding of the mechanisms involved in cognitive impairment in paediatric patients with MS.
There were 35 paediatric patients with MS included in the study and 16 sex- and age-matched controls. MRI sequences included brain dual-echo, diffusion-tensor, 3D T1-weighted and resting-state (RS) functional MRI (fMRI). Cognitively impaired patients were defined as patients with abnormalities in ≥2 neuropsychological tests and 45% of the patients were classified as cognitively impaired.

Voxel-wise analysis was used to assess the regional distribution of white matter and grey matter damage and default mode network (DMN) RS functional connectivity was also measured, since this is the most robust network identified by RS studies of the human brain.

The results showed that cognitively impaired patients had higher occurrence of T2 lesions and more severe damage to the white matter and grey matter in the posterior regions of the parietal lobes close to the midline (precuneus, posterior cingulum and corpus callosum). The cognitively impaired patients showed reduced RS functional connectivity of the precuneus, while cognitively preserved patients showed an increased RS functional connectivity of the anterior cingulate cortex.

Therefore, cognitive dysfunction in paediatric MS patients is associated with structural and functional abnormalities of the posterior regions of the DMN.

Authors: Rocca MA, Absinta M
Source: Neurology. 2014 Mar 19. [Epub ahead of print]
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