Author Of 1 Presentation
P0791 - Cerebellar dysfunction correlates with cognitive impairment in relapsing-remitting multiple sclerosis: A cross-sectional study (ID 1188)
Abstract
Background
MS-related damage to the cerebellum and cerebellar pathways may contribute to cognitive disability. Nevertheless, specific investigations regarding the relationship between cerebellar clinical dysfunction, volume loss, and cognitive impairment in relapsing-remitting MS (RRMS) are scarce.
Objectives
We aimed to investigate cognitive profile differences between RRMS patients with and without clinical signs of cerebellar dysfunction and to explore an association between cerebellar volume measures and cognitive performance in this RRMS cohort.
Methods
We designed a cross-sectional study, consecutively selecting RRMS patients followed at Egas Moniz Hospital’s MS Clinic, who had undergone cranial MRI evaluation at our center between July of 2018 and July of 2019, with a minimum follow-up period of 12 months before the scan. Cognitive status was evaluated through Symbol Digit Modalities Test (SDMT) and California Verbal Learning test II (CVLT-II). Whole-brain/cerebellar volumes were calculated using Freesurfer software, following standardized MR acquisition protocol. volBrain software was utilized to obtain cerebellar lobule segmentation and volumetric parameters. Posterior cerebellar volumes (PCV) were calculated as the sum of lobules VI–X. Patients were grouped according to the cerebellar functional system score (0 or >0) and between-group comparisons for demographic, clinical, and volume metrics were conducted. The relationship between cerebral/cerebellar volumes and clinical scores was investigated via hierarchical multiple linear regression analysis.
Results
42 patients (82% female) were included, with a median disease duration of 6 (11) years and median EDSS of 2.0 (1.0). 18 patients (42.9%) showed clinical signs of cerebellar dysfunction (PwsCD), defined by cerebellar Functional System Score of >0. SDMT (p=0.003) and CVLT-II (p=0.007) scores were significantly inferior in the PwsCD subgroup. Worse SDMT scores correlated with lower Crus II volume (r=0.374 ; p=0.015) and lower CVLT-II scores correlated with lower PCV (r=0.375; p=0.014) and Crus I volume (r=0,324; p=0,036). The regression model exploring the relationship between CVLT-II, demographical, and MRI variables (total brain volume and PCV) explained 36.4% of CVLT II variance (p=0.005), with PCV as a single independent predictor (p=0.036).
Conclusions
Correlations found between cognitive scores, posterior cerebellar volume, and specific lobules parallel previous studies describing a functional cerebellar dichotomy, with posterior areas predominantly involved in cognitive tasks. Cerebellar regional atrophy independently predicted cognitive performance in this RRMS cohort.