Cortical atrophy accelerates as cognitive decline worsens in multiple sclerosis
OBJECTIVETo determine which pathologic process could be responsible for the acceleration of cognitive decline during the course of multiple sclerosis (MS), using longitudinal structural MRI, which was related to cognitive decline in relapsing-remitting MS (RRMS) and progressive MS (PMS). METHODSA pr...
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| Veröffentlicht in: | Neurology 2019-10, Vol.93 (14), p.e1348-e1359 |
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| creator | Eijlers, Anand J.C Dekker, Iris Steenwijk, Martijn D Meijer, Kim A Hulst, Hanneke E Pouwels, Petra J.W Uitdehaag, Bernard M.J Barkhof, Frederik Vrenken, Hugo Schoonheim, Menno M Geurts, Jeroen J.G |
| description | OBJECTIVETo determine which pathologic process could be responsible for the acceleration of cognitive decline during the course of multiple sclerosis (MS), using longitudinal structural MRI, which was related to cognitive decline in relapsing-remitting MS (RRMS) and progressive MS (PMS).
METHODSA prospective cohort of 230 patients with MS (179 RRMS and 51 PMS) and 59 healthy controls was evaluated twice with 5-year (mean 4.9, SD 0.94) interval during which 22 patients with RRMS converted to PMS. Annual rates of cortical and deep gray matter atrophy as well as lesion volume increase were computed on longitudinal (3T) MRI data and correlated to the annual rate of cognitive decline as measured using an extensive cognitive evaluation at both time points.
RESULTSThe deep gray matter atrophy rate did not differ between PMS and RRMS (−0.82%/year vs −0.71%/year, p = 0.11), while faster cortical atrophy was observed in PMS (−0.87%/year vs −0.48%/year, p < 0.01). Similarly, faster cognitive decline was observed in PMS compared to RRMS (p < 0.01). Annual cognitive decline was related to the rate of annual lesion volume increase in stable RRMS (r = −0.17, p = 0.03) to the rate of annual deep gray matter atrophy in converting RRMS (r = 0.50, p = 0.02) and annual cortical atrophy in PMS (r = 0.35, p = 0.01).
CONCLUSIONSThese results indicate that cortical atrophy and cognitive decline accelerate together during the course of MS. Substrates of cognitive decline shifted from worsening lesional pathology in stable RRMS to deep gray matter atrophy in converting RRMS and to accelerated cortical atrophy in PMS only. |
| doi_str_mv | 10.1212/WNL.0000000000008198 |
| format | Article |
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METHODSA prospective cohort of 230 patients with MS (179 RRMS and 51 PMS) and 59 healthy controls was evaluated twice with 5-year (mean 4.9, SD 0.94) interval during which 22 patients with RRMS converted to PMS. Annual rates of cortical and deep gray matter atrophy as well as lesion volume increase were computed on longitudinal (3T) MRI data and correlated to the annual rate of cognitive decline as measured using an extensive cognitive evaluation at both time points.
RESULTSThe deep gray matter atrophy rate did not differ between PMS and RRMS (−0.82%/year vs −0.71%/year, p = 0.11), while faster cortical atrophy was observed in PMS (−0.87%/year vs −0.48%/year, p < 0.01). Similarly, faster cognitive decline was observed in PMS compared to RRMS (p < 0.01). Annual cognitive decline was related to the rate of annual lesion volume increase in stable RRMS (r = −0.17, p = 0.03) to the rate of annual deep gray matter atrophy in converting RRMS (r = 0.50, p = 0.02) and annual cortical atrophy in PMS (r = 0.35, p = 0.01).
CONCLUSIONSThese results indicate that cortical atrophy and cognitive decline accelerate together during the course of MS. Substrates of cognitive decline shifted from worsening lesional pathology in stable RRMS to deep gray matter atrophy in converting RRMS and to accelerated cortical atrophy in PMS only.</description><identifier>ISSN: 0028-3878</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/WNL.0000000000008198</identifier><identifier>PMID: 31484713</identifier><language>eng</language><publisher>United States: American Academy of Neurology</publisher><subject>Adult ; Aged ; Atrophy - diagnostic imaging ; Atrophy - epidemiology ; Atrophy - psychology ; Cerebral Cortex - diagnostic imaging ; Cognitive Dysfunction - diagnostic imaging ; Cognitive Dysfunction - epidemiology ; Cognitive Dysfunction - psychology ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Longitudinal Studies ; Magnetic Resonance Imaging - trends ; Male ; Middle Aged ; Multiple Sclerosis - diagnostic imaging ; Multiple Sclerosis - epidemiology ; Multiple Sclerosis - psychology ; Prospective Studies</subject><ispartof>Neurology, 2019-10, Vol.93 (14), p.e1348-e1359</ispartof><rights>2019 American Academy of Neurology</rights><rights>2019 American Academy of Neurology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4078-b8e5bf3942a0bcd2bd565ce22a2f945dca16795a266860bc6cafdd5c82bbd7ef3</citedby><cites>FETCH-LOGICAL-c4078-b8e5bf3942a0bcd2bd565ce22a2f945dca16795a266860bc6cafdd5c82bbd7ef3</cites><orcidid>0000-0002-2504-6959 ; 0000-0002-6651-574X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31484713$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eijlers, Anand J.C</creatorcontrib><creatorcontrib>Dekker, Iris</creatorcontrib><creatorcontrib>Steenwijk, Martijn D</creatorcontrib><creatorcontrib>Meijer, Kim A</creatorcontrib><creatorcontrib>Hulst, Hanneke E</creatorcontrib><creatorcontrib>Pouwels, Petra J.W</creatorcontrib><creatorcontrib>Uitdehaag, Bernard M.J</creatorcontrib><creatorcontrib>Barkhof, Frederik</creatorcontrib><creatorcontrib>Vrenken, Hugo</creatorcontrib><creatorcontrib>Schoonheim, Menno M</creatorcontrib><creatorcontrib>Geurts, Jeroen J.G</creatorcontrib><title>Cortical atrophy accelerates as cognitive decline worsens in multiple sclerosis</title><title>Neurology</title><addtitle>Neurology</addtitle><description>OBJECTIVETo determine which pathologic process could be responsible for the acceleration of cognitive decline during the course of multiple sclerosis (MS), using longitudinal structural MRI, which was related to cognitive decline in relapsing-remitting MS (RRMS) and progressive MS (PMS).
METHODSA prospective cohort of 230 patients with MS (179 RRMS and 51 PMS) and 59 healthy controls was evaluated twice with 5-year (mean 4.9, SD 0.94) interval during which 22 patients with RRMS converted to PMS. Annual rates of cortical and deep gray matter atrophy as well as lesion volume increase were computed on longitudinal (3T) MRI data and correlated to the annual rate of cognitive decline as measured using an extensive cognitive evaluation at both time points.
RESULTSThe deep gray matter atrophy rate did not differ between PMS and RRMS (−0.82%/year vs −0.71%/year, p = 0.11), while faster cortical atrophy was observed in PMS (−0.87%/year vs −0.48%/year, p < 0.01). Similarly, faster cognitive decline was observed in PMS compared to RRMS (p < 0.01). Annual cognitive decline was related to the rate of annual lesion volume increase in stable RRMS (r = −0.17, p = 0.03) to the rate of annual deep gray matter atrophy in converting RRMS (r = 0.50, p = 0.02) and annual cortical atrophy in PMS (r = 0.35, p = 0.01).
CONCLUSIONSThese results indicate that cortical atrophy and cognitive decline accelerate together during the course of MS. Substrates of cognitive decline shifted from worsening lesional pathology in stable RRMS to deep gray matter atrophy in converting RRMS and to accelerated cortical atrophy in PMS only.</description><subject>Adult</subject><subject>Aged</subject><subject>Atrophy - diagnostic imaging</subject><subject>Atrophy - epidemiology</subject><subject>Atrophy - psychology</subject><subject>Cerebral Cortex - diagnostic imaging</subject><subject>Cognitive Dysfunction - diagnostic imaging</subject><subject>Cognitive Dysfunction - epidemiology</subject><subject>Cognitive Dysfunction - psychology</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Magnetic Resonance Imaging - trends</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multiple Sclerosis - diagnostic imaging</subject><subject>Multiple Sclerosis - epidemiology</subject><subject>Multiple Sclerosis - psychology</subject><subject>Prospective Studies</subject><issn>0028-3878</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1OwzAQhC0EoqXwBgj5yCXFdmLHOaKKP6miFxDcIsfZUIOTFNuh6ttj1IIQB_ayh_1mdjQInVIypYyyi6f7-ZT8GkkLuYfGlDORiJQ976MxIUwmqczlCB15_0pIPObFIRqlNJNZTtMxWsx6F4xWFqvg-tVyg5XWYMGpAB4rj3X_0plgPgDXoK3pAK9756Hz2HS4HWwwKwvY6yjpvfHH6KBR1sPJbk_Q4_XVw-w2mS9u7maX80RnJJdJJYFXTVpkTJFK16yqueAaGFOsKTJea0VFXnDFhJAiEkKrpq65lqyq6hyadILOt74r178P4EPZGh-DW9VBP_iSMckpSSnlEc22qI4JvYOmXDnTKrcpKSm_qixjleXfKqPsbPdhqFqof0Tf3UVAboF1bwM4_2aHNbhyCcqG5f_en7Czgek</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Eijlers, Anand J.C</creator><creator>Dekker, Iris</creator><creator>Steenwijk, Martijn D</creator><creator>Meijer, Kim A</creator><creator>Hulst, Hanneke E</creator><creator>Pouwels, Petra J.W</creator><creator>Uitdehaag, Bernard M.J</creator><creator>Barkhof, Frederik</creator><creator>Vrenken, Hugo</creator><creator>Schoonheim, Menno M</creator><creator>Geurts, Jeroen J.G</creator><general>American Academy of Neurology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2504-6959</orcidid><orcidid>https://orcid.org/0000-0002-6651-574X</orcidid></search><sort><creationdate>20191001</creationdate><title>Cortical atrophy accelerates as cognitive decline worsens in multiple sclerosis</title><author>Eijlers, Anand J.C ; Dekker, Iris ; Steenwijk, Martijn D ; Meijer, Kim A ; Hulst, Hanneke E ; Pouwels, Petra J.W ; Uitdehaag, Bernard M.J ; Barkhof, Frederik ; Vrenken, Hugo ; Schoonheim, Menno M ; Geurts, Jeroen J.G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4078-b8e5bf3942a0bcd2bd565ce22a2f945dca16795a266860bc6cafdd5c82bbd7ef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Atrophy - diagnostic imaging</topic><topic>Atrophy - epidemiology</topic><topic>Atrophy - psychology</topic><topic>Cerebral Cortex - diagnostic imaging</topic><topic>Cognitive Dysfunction - diagnostic imaging</topic><topic>Cognitive Dysfunction - epidemiology</topic><topic>Cognitive Dysfunction - psychology</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Magnetic Resonance Imaging - trends</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multiple Sclerosis - diagnostic imaging</topic><topic>Multiple Sclerosis - epidemiology</topic><topic>Multiple Sclerosis - psychology</topic><topic>Prospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eijlers, Anand J.C</creatorcontrib><creatorcontrib>Dekker, Iris</creatorcontrib><creatorcontrib>Steenwijk, Martijn D</creatorcontrib><creatorcontrib>Meijer, Kim A</creatorcontrib><creatorcontrib>Hulst, Hanneke E</creatorcontrib><creatorcontrib>Pouwels, Petra J.W</creatorcontrib><creatorcontrib>Uitdehaag, Bernard M.J</creatorcontrib><creatorcontrib>Barkhof, Frederik</creatorcontrib><creatorcontrib>Vrenken, Hugo</creatorcontrib><creatorcontrib>Schoonheim, Menno M</creatorcontrib><creatorcontrib>Geurts, Jeroen J.G</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eijlers, Anand J.C</au><au>Dekker, Iris</au><au>Steenwijk, Martijn D</au><au>Meijer, Kim A</au><au>Hulst, Hanneke E</au><au>Pouwels, Petra J.W</au><au>Uitdehaag, Bernard M.J</au><au>Barkhof, Frederik</au><au>Vrenken, Hugo</au><au>Schoonheim, Menno M</au><au>Geurts, Jeroen J.G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cortical atrophy accelerates as cognitive decline worsens in multiple sclerosis</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2019-10-01</date><risdate>2019</risdate><volume>93</volume><issue>14</issue><spage>e1348</spage><epage>e1359</epage><pages>e1348-e1359</pages><issn>0028-3878</issn><eissn>1526-632X</eissn><abstract>OBJECTIVETo determine which pathologic process could be responsible for the acceleration of cognitive decline during the course of multiple sclerosis (MS), using longitudinal structural MRI, which was related to cognitive decline in relapsing-remitting MS (RRMS) and progressive MS (PMS).
METHODSA prospective cohort of 230 patients with MS (179 RRMS and 51 PMS) and 59 healthy controls was evaluated twice with 5-year (mean 4.9, SD 0.94) interval during which 22 patients with RRMS converted to PMS. Annual rates of cortical and deep gray matter atrophy as well as lesion volume increase were computed on longitudinal (3T) MRI data and correlated to the annual rate of cognitive decline as measured using an extensive cognitive evaluation at both time points.
RESULTSThe deep gray matter atrophy rate did not differ between PMS and RRMS (−0.82%/year vs −0.71%/year, p = 0.11), while faster cortical atrophy was observed in PMS (−0.87%/year vs −0.48%/year, p < 0.01). Similarly, faster cognitive decline was observed in PMS compared to RRMS (p < 0.01). Annual cognitive decline was related to the rate of annual lesion volume increase in stable RRMS (r = −0.17, p = 0.03) to the rate of annual deep gray matter atrophy in converting RRMS (r = 0.50, p = 0.02) and annual cortical atrophy in PMS (r = 0.35, p = 0.01).
CONCLUSIONSThese results indicate that cortical atrophy and cognitive decline accelerate together during the course of MS. Substrates of cognitive decline shifted from worsening lesional pathology in stable RRMS to deep gray matter atrophy in converting RRMS and to accelerated cortical atrophy in PMS only.</abstract><cop>United States</cop><pub>American Academy of Neurology</pub><pmid>31484713</pmid><doi>10.1212/WNL.0000000000008198</doi><orcidid>https://orcid.org/0000-0002-2504-6959</orcidid><orcidid>https://orcid.org/0000-0002-6651-574X</orcidid></addata></record> |
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| subjects | Adult Aged Atrophy - diagnostic imaging Atrophy - epidemiology Atrophy - psychology Cerebral Cortex - diagnostic imaging Cognitive Dysfunction - diagnostic imaging Cognitive Dysfunction - epidemiology Cognitive Dysfunction - psychology Cohort Studies Female Follow-Up Studies Humans Longitudinal Studies Magnetic Resonance Imaging - trends Male Middle Aged Multiple Sclerosis - diagnostic imaging Multiple Sclerosis - epidemiology Multiple Sclerosis - psychology Prospective Studies |
| title | Cortical atrophy accelerates as cognitive decline worsens in multiple sclerosis |
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