Cortical Lesions Have Significance in Multiple Sclerosis

Researchers have identified possible key characteristics of a cortically dominant multiple sclerosis (MS) subtype. The research was conducted by Olivia Geisseler, PhD student, in the Department of Neurology at the University Hospital in Zurich and colleagues and was published in BMC Neurology on October 21, 2016.

The researchers say that in the present study they “apply a novel methodological approach to investigate the clinical relevance of cortical lesions in MS, i.e. by dichotomizing patients based on the presence or absence of cortical lesions.” The result was two groups which were compared “with regard to demography, cognition, fatigue, affective mood state, and several other established MRI markers of disease severity,” say the authors.

There were 42 participants diagnosed with relapsing remitting multiple sclerosis (RRMS) recruited from a single center. Of those, 32 were assigned to the cortical lesion group and 10 were in the non-cortical lesion group. They were matched with 43 healthy controls. “All patients received immunomodulatory treatment — 30 with natalizumab, seven with beta-interferons, three with fingolimod, and one with glatiramer acetate and one with dimethylfumarate,” report the authors.

“The most intriguing finding of the present study was that the patients with — compared to those without visible cortical lesions -- differed from each other in global cortical thickness and mnestic functions, whereas no differences between these two patient groups were observed regarding EDSS [Expanded Disability Status Scale], age, age at diagnosis, disease duration, or non-mnestic cognitive functions,” say the researchers.

The researchers say that because the present study approached the investigation from the imaging side, the results “may reflect a different and somehow incomplete variant of cortical MS.” Additionally, the researchers note, “both patient groups showed executive deficits compared to the healthy control group,” which is a finding in line with previous research.

The present study does have limitations, including the small sample size and the low MRI field, among others. However, acknowledging those limitations, the researchers conclude, “the occurrence of cortical lesions in MS is clinically relevant insofar as it is associated with neurodegenerative cortical thinning and mnestic dysfunction.”

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