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Saturday, October 21, 2017

Looking into cognitive impairment in Primary-Progressive Multiple Sclerosis.

Petracca M, et al. Eur J Neurol. 2017.


BACKGROUND: Cognitive impairment in primary-progressive multiple sclerosis (PP-MS) is correlated with global brain atrophy. Unfortunately, brain volumes computation requires processing resources not widely available in clinical practice. Therefore we decided to test the predictive role of retinal atrophy metrics on cognitive decline, applying them as proxy of grey matter (GM) atrophy in PP-MS.
METHODS: Twenty-five PP-MS patients completed the Brief International Cognitive Assessment for MS (BICAMS) and underwent spectral-domain OCT and 3.0 Tesla MRI. Through a stepwise logistic regression we tested whether OCT metrics (retinal nerve fiber layer-RNFL, ganglion cell+inner plexiform layer-GCIPL, total macular volume-TMV) predicted cognitive impairment and explored the role of GM atrophy in mediating these correlations.
RESULTS: Among OCT metrics, only GCIPL was associated with cognitive impairment (rp =.448, p=.036) and predictive of objective cognitive impairment (Wald [1]=4.40, p=.036). Controlling for demographics, normalized brain volume (NBV) and thalamic volume were correlated with GCIPL (respectively rp =.427, p=.047 and rp =.674, p=.001) and cognitive scores (respectively rp =.593, p=.004 and rp =.501, p=.017), with thalamic volume nearly mediating the association between GCIPL and cognition (Sobel z=1.86, p=.063).
CONCLUSIONS: GCIPL thickness is a suitable measure of neurodegeneration. In comparison with brain atrophy, GCIPL offers higher histopathological specificity, being a pure correlate of neuronal loss and may be a noninvasive, easy-to-perform way to quantitatively evaluate and monitor neuronal loss related to cognitive impairment in PP-MS. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.


 29053884 [PubMed - as supplied by publisher]

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