Longitudinal Evaluation of the Relation of Imaging Measures to Cognitive Decline in Multiple Sclerosis
Abstract
About half of all patients with multiple sclerosis (MS) show some decline in cognitive abilities. Problems with cognition can be one of the more debilitating symptoms of MS, impacting employment, family and social relationships, and daily living skills. There are currently no measures that can predict which patients will experience cognitive dysfunction. Memory impairment is one of the most common types of cognitive symptoms, and the goal of this project is to identify magnetic resonance imaging (MRI) measures that track and predict memory impairment. A measure that can estimate the risk of memory impairment for an individual patient can give clinicians and patients more information on which to base treatment decisions. Our previous work identified a number of MRI measures that show potential for predicting and monitoring cognitive function. Measures of the integrity of brain tissue, the size of specific brain regions, and the relationships between brain regions were all strongly related to performance on tests of memory in patients with MS but not in controls. This research will test how well those measures predict memory dysfunction. We will test 80 patients with MS over two sessions with 1 year in between. Participants will complete MRI scanning and a battery of cognitive tests at each session. A subset of the participants will come back for a third session that will consist of cognitive testing only. We will use imaging measures to try to predict memory loss. If the imaging measures studied in this proposal accurately identify which patients are at risk for memory problems, the most noticeable impact for patients would be having the option of finding out if they are at risk. All patients could potentially benefit from a measure of risk, giving the patients, their families, and their doctors valuable information that will allow more informed decisions in both medical treatment and daily living. Predictive measures will also allow the administration of drug treatment to protect against cognitive decline before a patient shows symptoms of decline on cognitive tests, which may be when treatment is most effective. A measure that tracks cognitive decline would be most useful in evaluation of potential drug therapies, as it would provide a biological measure of drug effectiveness. The risks of the proposed research are minimal and are the same as those encountered with a clinical MRI. Ideally, future application of these measures would be tied in to regular clinical scanning protocols and would not represent a significant increase in patient MRI time. The proposed research represents a step in the process of identifying, validating, and refining measures that are related to memory dysfunction in MS. The outcomes of this work will be estimates of predictive value for each of the measures we propose. If the predictive value is high, the next step will be to develop shorter and more robust scans so that the same measures can be easily collected in large numbers of patients. It is likely that participants in large-scale drug trials would be the first to receive scans of this nature, with routine clinical scanning coming after further refinement.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610446
Entities
People
- Katherine Anne Koenig
Organizations
- Cleveland Clinic
- United States Army