Background Cognitive impairment (CI) is common in multiple sclerosis (MS) yet poorly captured by conventional disability scales. Although neuropsychological assessment and magnetic resonance imaging (MRI) are routinely used separately, there is no simple clinically applicable framework integrating cognitive performance with structural brain changes to identify patients at increased risk of cognitive decline. Integrating neuropsychological testing with MRI-based atrophy metrics may yield clinically useful cognitive phenotypes with differential patterns of brain atrophy measures. Methods Data were collected from 79 patients with multiple sclerosis (PwMS) who underwent comprehensive neuropsychological assessment and brain MRI. Neuropsychological variables were subjected to a feature selection procedure based on variance and quartile coefficient of dispersion filtering, followed by Pearson correlation and mutual information (MI) analyses to generate reduced feature sets. These feature sets were used as input for unsupervised clustering with the Partitioning Around Medoids (PAM) algorithm to identify cognitive phenotypes. Differences between the resulting groups in the degree of brain atrophy measures were subsequently evaluated using appropriate statistical tests—one-way ANOVA or the Kruskal–Wallis test. Post hoc analysis was performed using a pairwise t-test, Welch's t-test, or Wilcoxon test with the Holm-Bonferroni correction, depending on the data distribution and variance. Results The feature selection procedure based on variance and mutual information identified neuropsychological features that were subsequently used for clustering. Based on these features, the PAM algorithm identified three distinct groups of PwMS that differed in their clinical characteristics, degree of brain atrophy measures, and cognitive phenotype, ranging from preserved cognition to global cognitive impairment. Conclusion Three cognitive phenotypes with differential patterns of brain atrophy measures integrate neuropsychological testing with MRI measures into a clinically applicable framework that may help bridge the gap between structural imaging findings and everyday cognitive assessment in PwMS. This approach may improve screening, enable earlier detection of CI, improve monitoring, and provide valuable information for rehabilitation planning.
Patrycja Romaniszyn-Kania, Weronika Galus, Julia Wyszomirska et al.· Frontiers in Neuroscience· 0 citations
Highlights What are the main findings? Larger choroid plexus volume was associated in several studies with poorer cognition in MS, particularly processing speed and visuospatial memory. Longitudinal evidence did not show consistent predictive value for choroid plexus volume; one study suggested prognostic value of the CP T1/T2 ratio. What are the implications of the main findings? Choroid plexus volume and microstructural measures are promising MRI research markers, but not yet established clinical biomarkers. Harmonized acquisition and segmentation and adequately powered longitudinal, multidomain studies are needed. Abstract Background/Objectives: Multiple sclerosis (MS) is frequently accompanied by cognitive impairment, yet the neurobiological mechanisms underlying cognitive heterogeneity remain incompletely understood. The choroid plexus (CP), a blood–CSF barrier structure involved in cerebrospinal fluid production and neuroimmune signaling, has recently emerged as a potential MRI marker of inflammatory and neurodegenerative activity in MS. This scoping review mapped evidence on associations between CP features and cognitive functions in adults with MS. Methods: A broad search of PubMed, Scopus, Web of Science Core Collection, and the Cochrane Library identified 1163 records; after deduplication, screening, and full-text assessment, seven studies were included. Results: CP volume or normalized CP volume was assessed in all seven studies, and one study additionally examined the CP T1/T2 ratio. The Symbol Digit Modalities Test was used in six studies, while five applied multidomain cognitive assessment. Larger CP volume was associated in several studies with poorer baseline information-processing speed, visuospatial memory, or multidomain cognition, but longitudinal findings did not show consistent predictive value for CP volume. One study reported that a higher CP T1/T2 ratio predicted faster visuospatial-memory decline. Conclusions: CP-related measures may reflect broader neuroinflammatory and neurodegenerative processes relevant to cognition in MS, but the evidence remains limited and methodologically heterogeneous. Standardized acquisition and segmentation, harmonized cognitive assessment, and adequately powered longitudinal studies are needed to establish their independent and predictive value.
Weronika Galus, Patrycja Romaniszyn-Kania, Aleksandra Urantówka et al.· Brain Science· 0 citations