Cognitive impairment starts early in MS

Objective: This study assessed whether abnormalities on functional magnetic resonance imaging (fMRI) are related to cognitive function in people at presentation with clinically isolated syndrome (CIS) suggestive of MS. 

fMRI is a tool that allows investigators to assess the functioning of specific regions of the brain by assessing the blood flow to that region; the more active a region the greater the blood flow, the less active a region the less the blood flow. 

Methods: 18 people with CIS and 15 healthy controls performed an adapted fMRI version of the Paced Auditory Serial Addition Test (PASAT); a cognitive test. According to their PASAT performance, CIS patients were divided into two groups: 10 with a low PASAT performance were considered to be 'cognitively impaired' (CI) and 8 were defined as 'cognitively preserved' (CP). Between-group differences in the patterns of brain activations and effective connectivity were assessed. 

Results: During PASAT, compared to HCs, CIS patients showed increased activation of several areas of the brain. 

When CIS'ers were analyzed, the CI group had a more significant activation than HCs and CP CIS'ers.

Conclusions: During performance of the PASAT, CIS'ers showed abnormalities in the patterns of brain function and connectivity related to the level of their cognitive impairment as measured by the PASAT test.

Epub ahead of printForn et al. Functional magnetic resonance imaging correlates of cognitive performance in patients with a clinically isolated syndrome suggestive of multiple sclerosis at presentation: an activation and connectivity study. Mult Scler. 2011 Aug 9. 

"More reason to treat early and to consider aggressive treatment strategies; cognition is a very valuable function that is not captured with our current outcome measures."

"This study supports other findings in the field; in other words this data is reproducible (the most important principle in science) and consistent with other findings in the field (an important second principle of scientific discovery)."

"Reproducibility & Consistency with other findings!"

Additional reading: fMRI, PASAT

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