Cortical lesions predict cognitive impairment 20 years after MS diagnosis

The number of cortical lesions at the time of MS diagnosis could accurately predict cognitive impairment 20 years after the diagnosis of the disease. A predictive model showed that patients who displayed 3 or more cortical lesions at diagnosis had a 4-fold higher risk of developing severe cognitive impairment at 20 years of follow-up [1].

Cortical lesions reflect brain damage in patients with MS [2]. However, the role of early cortical lesions in predicting long-term cognitive impairment has yet to be clarified. Therefore, the current study aimed to assess the prognostic capacity of cortical lesions at MS diagnosis regarding cognitive impairment after 20 years of MS. The study included 170 patients with MS, who received a 1.5T MRI scan within 3 years from MS diagnosis to evaluate cortical lesions. Furthermore, a neuropsychological assessment was conducted to assess cognitive status at 20 years follow-up. Mr Stefano Ziccardi (University of Verona, Italy) presented the study results.

Patients who were cognitively impaired at 20 years of follow-up had a significantly higher number of cortical lesions at diagnosis (median 3.0) than patients without cognitive impairment at follow-up (median 0.0). Moreover, there was a significant difference in the number of cortical lesions at diagnosis between patients with mild cognitive impairment (median 2.0) and patients with severe cognitive impairment (median 4.0). Logistic regression analysis showed that patients with ≥3 cortical lesions at diagnosis had approximately a 4-fold risk of cognitive impairment at follow-up (OR 3.70; 95% CI 1.8–7.5; P<0.001). In addition, these patients were at higher risk of severe cognitive impairment after 20 years of disease (OR 3.33; 95% CI 1.49–4.17; P=0.01). These results suggest that early cortical lesion evaluation in MS patients could predict cognitive alterations in the future. Early recognition of these lesions is necessary in order to improve the diagnosis and monitoring of cognitive abilities in patients with MS, and to enable swift interventions.

1. Ziccardi S, et al. Cortical lesions at diagnosis predict cognitive impairment in multiple sclerosis: a 20-year follow-up study. OP49, ECTRIMS 2021 Virtual Congress, 13–15 October.
2. Calabrese M, et al. Arch Neurol. 2009;66(9):1144–50.

 

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Posted on 9 December 20219 December 2021