A longitudinal study of MRI and neuropsychological measures in patients with multiple sclerosis

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system. Demyelinisation and neuronal degeneration results in focal loss of function. Sensory and motor deficiencies are central, but around half of the patients have got psy chiatric and neuropsychological symptoms. The onset of MS is most often in 20-40 years of age. More women than men are affected, and Norway is a zone of high prevalence. MRI (magnetic resonance imaging) is important in diagnosing MS. This radiological mo dality has over the years become the gold standard procedure for describing cerebral pathology in MS patients. Conventional MRI, which is the MRI used for everyday clinical practice, include assessment of volume, count and localization lesions in the brai n. There has for some time been a "clinical-radiological paradox" in multiple sclerosis. This is because the lesion-load has been only weakly with physical disability in earlier cross-sectional studies. Many recent articles have found that cerebral atroph y has a stronger association with clinical status. The last years there have also been more and more focus on neuropsychological dysfunction and psychiatric symptoms in MS. Such problems have a major impact on the patient's quality of life and psychosocia l function. Studies on atrophy and for instance impairment of memory have found significant loss of brain tissue. My project will focus on the occurrence and development of cerebral atrophy in MS. I will analyze 80 patients with cerebral MRI, clinical, ep idemiological and neuropsychological data at baseline 2001 and 5 year follow up in 2006. The mail goals will be to obtain more knowledge about cerebral atrophy in multiple sclerosis, especially regarding the development of regional atrophy. This is import ant for instance for planning of future clinical trials. I will focus on cognitive dysfunction. Can atrophy serve as a neuronal marker for this? And can atrophy predict future cognitive problems in MS?