CG21
MRI and CSF Analysis of Cognitive Impairment in MS
Thursday, May 29, 2014
Trinity Exhibit Hall
Geeta Ganesh, MD
,
Neurology, Atlanta Veterans Administration Medical Center, Decatur, GA
William Tyor, MD
,
Neurology, Atlanta Veterans Administration Medical Center, Decatur, GA
Amit Saindane, MD
,
Radiology, Emory University School of Medicine, Atlanta, GA
Eric Wandler, MD
,
Neurology, Atlanta Veterans Administration Medical Center, Decatur, GA
Daniel Drane, PhD
,
Neurology, Emory University School of Medicine, Atlanta, GA
Background: Forty to 60% of multiple sclerosis (MS) patients experience cognitive decline, particularly in the areas of complex attention, information processing speed, episodic memory, and executive function. Studies utilizing magnetic resonance imaging (MRI) suggest that the severity of cognitive decline may be related to the degree of brain atrophy, although the correlation is not strong, suggesting complex factors in the pathogenesis of cognitive dysfunction in MS. Cerebrospinal fluid (CSF) biomarkers of neuro-degeneration have been analyzed for different types of dementias, such as Alzheimer’s dementia. These markers, such as A-beta-42 protein and Tau, have not been evaluated in MS patients. Additionally, inflammatory CSF markers, such as interferon-alpha (IFN-alpha), have been associated with cognitive dysfunction in, for example, HIV-associated neurocognitive disorders (HAND). It is possible that these biomarkers, in conjunction with certain brain MRI findings, may predict the severity of cognitive decline in relapsing remitting MS patients
Objectives: The purpose of this ongoing study is to identify brain MRI patterns and CSF biomarkers in cognitively impaired relapsing remitting MS patients.
Methods: NeuroQuant® Software will be used to measure various aspects of brain atrophy, for example hippocampal volumes. Double inversion recovery (DIR) SPACE will be used to evaluate grey matter lesion load, and diffusion kurtosis imaging (DKI) will be used to evaluate white matter integrity at 3.0-Tesla. CSF analysis will include measurement of A-beta-42 protein, Tau, IFN-alpha and other neurodegenerative and inflammatory markers.
Results: Data is currently being collected for this study. We hypothesize that cognitively impaired relapsing remitting MS patients will have a greater degree of hippocampal atrophy, greater grey matter lesion volume, and greater reductions in white matter fractional anisotropy on MRI. Also, these patients will have greater levels of CSF inflammatory and neurodegenerative biomarkers compared to MS patients who are not cognitively impaired.
Conclusions: Not applicable
