HealthDay News — Diffusion tensor imaging metrics reveal distinct white matter integrity in patients with cognitively preserved and cognitively impaired multiple sclerosis (MS), study results suggest.

To better understand whether diffusion tensor imaging signifies cognitive impairment in MS, Hanneke E. Hulst, of the VU University Medical Center in Amsterdam, and colleagues performed imaging studies and analyzed outcomes in a cohort of 55 patients with MS and 30 healthy controls. Findings were published online in Neurology.

Among the participants with MS, 35 had cognitively preserved forms of the disease, whereas 20 had cognitively impaired forms. The researchers observed decreased fractional anisotrophy in 49% of the white matter skeleton of cognitively preserved patients vs. 76% of the white matter investigated in cognitively impaired patients, compared with healthy controls.

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Decreased fractional anisotrophy was seen for both MS groups in areas including the corpus callosum, superior and inferior longitudinal fasciculus, corticospinal tracts, forceps major, cingulum and fornices, but was significantly worse for cognitively impaired patients.

Cognitively impaired patients also exhibited damage to the integrity of white matter in cortical brain areas, thalamus, uncinate fasciculus, brainstem and cerebellum. These changes did not depend on the location of lesions or on regional gray matter volume.

“White matter integrity changes were found in areas that are highly relevant for cognition in the cognitively impaired patients, but not in the cognitively preserved patients,” the researchers wrote. “These white matter changes are therefore thought to be related to the cognitive deficits and suggest that diffusion tensor imaging might be a powerful tool when monitoring cognitive impairment in MS.”


  1. Hulst HE et al. Neurology 10.1212/WNL.0b013e31828726cc.