Imaging Correlates of Plaque Location and Cognitive Dysfunction in Multiple Sclerosis

Background: Cognitive dysfunction plays a significant role in the disease course of multiple sclerosis (MS), yet the imaging correlates of these cognitive changes are not fully understood. Objectives: This study explores the association between plaque location on magnetic resonance imaging (MRI) and cognitive dysfunction in MS. Methods: This cross-sectional study involved 100 subjects diagnosed with relapsing-remitting MS (RRMS), aged 18 - 55 years, who underwent brain MRI between March 2020 and March 2024 at Besat Clinic Imaging Center, Kerman, Iran. Cognitive function was assessed using the montreal cognitive assessment (MoCA) within one week of MRI. The relationship between plaque location and cognitive impairment was analyzed using SPSS version 25. Results: Of the total participants, 76% were categorized as cognition preserved (CP) and 24% as cognition impaired (CI). No significant differences in average age, disease duration, treatment duration, or comorbidities were found between CP and CI patients. However, CI patients had significantly more demyelinating plaques in the frontal lobe and corpus callosum (P = 0.006 for frontal lobe, P = 0.004 for corpus callosum) compared to CP patients. Conclusions: The distribution of demyelinating plaques in the frontal lobe and corpus callosum may contribute to cognitive dysfunction in MS patients.