Frederic Blanc1,2,3*, Vincent Noblet4, Barbara Jung1,3, François Rousseau4, Felix Renard2,4, Bertrand Bourre1,2, Nadine Longato1,3, Nadjette Cremel1,3, Laure Di Bitonto1,3, Catherine Kleitz1,3, Nicolas Collongues1,2, Jack Foucher5, Stephane Kremer2,6, Jean-Paul Armspach2, Jerome de Seze1,2
1 Neuropsychology Service, Department of Neurology, University Hospital of Strasbourg, Strasbourg, France, 2 LINC (Cognitive Neurosciences and Imagery Laboratory), UMR 7237, University of Strasbourg and CNRS, Strasbourg, France, 3 CMRR (Memory Resource and Research Centre), Department of Neurology, University Hospital of Strasbourg, Strasbourg, France, 4 LSIIT (Image Science, Computer Science and Remote Sensing Laboratory), UMR 7005, University of Strasbourg and CNRS, Strasbourg, France, 5 INSERM U666, University Hospital of Strasbourg, Strasbourg, France, 6 Neuroradiology service, University Hospital of Strasbourg, Strasbourg, France
Abstract Top
Neuromyelitis optica (NMO) is an inflammatory disease of central nervous system characterized by optic neuritis and longitudinally extensive acute transverse myelitis. NMO patients have cognitive dysfunctions but other clinical symptoms of brain origin are rare. In the present study, we aimed to investigate cognitive functions and brain volume in NMO. The study population consisted of 28 patients with NMO and 28 healthy control subjects matched for age, sex and educational level. We applied a French translation of the Brief Repeatable Battery (BRB-N) to the NMO patients. Using SIENAx for global brain volume (Grey Matter, GM; White Matter, WM; and whole brain) and VBM for focal brain volume (GM and WM), NMO patients and controls were compared. Voxel-level correlations between diminished brain concentration and cognitive performance for each tests were performed. Focal and global brain volume of NMO patients with and without cognitive impairment were also compared. Fifteen NMO patients (54%) had cognitive impairment with memory, executive function, attention and speed of information processing deficits. Global and focal brain atrophy of WM but not Grey Matter (GM) was found in the NMO patients group. The focal WM atrophy included the optic chiasm, pons, cerebellum, the corpus callosum and parts of the frontal, temporal and parietal lobes, including superior longitudinal fascicle. Visual memory, verbal memory, speed of information processing, short-term memory and executive functions were correlated to focal WM volumes. The comparison of patients with, to patients without cognitive impairment showed a clear decrease of global and focal WM, including brainstem, corticospinal tracts, corpus callosum but also superior and inferior longitudinal fascicles. Cognitive impairment in NMO patients is correlated to the decreased of global and focal WM volume of the brain. Further studies are needed to better understand the precise origin of cognitive impairment in NMO patients, particularly in the WM.
Read More: PLoS ONE: White Matter Atrophy and Cognitive Dysfunctions in Neuromyelitis Optica