19/3/2019 Correlating brain atrophy with cognitive dysfunction, mood disturbances, and personality disorder in multiple sclerosis.

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J Neuroimaging. 2004 Jul;14(3 Suppl):36S-45S.

Correlating brain atrophy with cognitive dysfunction, mood

disturbances, and personality disorder in multiple sclerosis.
Benedict RH1, Carone DA, Bakshi R.

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Abstract
Neuropsychological impairment is a common feature of multiple sclerosis. Affected patients often
have deficits in information-processing speed and memory and exhibit psychopathological states such
as depression. A minority of patients have rarer affect/mood disorders such as euphoria sclerotica
and pathological laughter/crying. Neuropsychological impairment is a major predictor of low quality of
life, unemployment, and caregiver distress. Studies evaluating correlations between
neuropsychological impairment and findings on magnetic resonance imaging show that
neuropsychological dysfunction is associated with lesion burden and diffuse disease in normal-
appearing brain tissue. However, measures of tissue atrophy including whole-brain and central atrophy
are especially well correlated with and predictive of cognitive impairment. Moreover, recent studies
have shown that conventional measures of brain atrophy explain more variance in neuropsychological
dysfunction than do measures of lesion burden. In particular, neuropsychological outcomes correspond
highly with linear measures of subcortical atrophy such as ventricle enlargement. Within the domain of
emotional dysfunction, both lesion burden and atrophy are related to major depressive disorder. Brain
atrophy also predicts euphoria and disinhibition. The preliminary data suggest that although lesion
burden primarily predicts depressive disorder, both lesion burden and atrophy predict the presence of
euphoria. Euphoria and disinhibition likely represent personality change associated with worsening
cognition as the disease progresses. Taken together, this growing body of data on magnetic
resonance imaging to neuropsychological correlations supports the clinical relevance and validity of
brain atrophy as a measure of disease progression in multiple sclerosis. Continuing research focuses
on the possible relationship between measures of regional brain atrophy and cognitive and emotional
impairment.

PMID: 15228758 DOI: 10.1177/1051228404266267

[Indexed for MEDLINE]

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https://www.ncbi.nlm.nih.gov/pubmed/15228758 1/2
19/3/2019 Correlating brain atrophy with cognitive dysfunction, mood disturbances, and personality disorder in multiple sclerosis. - PubMed - NCBI

https://www.ncbi.nlm.nih.gov/pubmed/15228758 2/2