Neuropsychological impairment in multiple sclerosis patients: the role of (juxta)cortical lesion on FLAIR

In this study we evaluated the correlation between neuropsychological impai rment (measured with the Brief Repeatable Battery Neuropsychological Tests) and (juxta)cortical lesions detected with FLAIR and the relative sensitivi ty of the FLAIR sequence compared to spin-echo MRI sequences in detecting ( juxta)cortical MS lesions. A total of 39 patients with definite MS were eva luated by MRI with a conventional and fast spin echo sequence and fast FLAI R sequence, and neuropsychological tests of the Brief Repeatable Battery Ne uropsychological rests were performed The Z-score of all subtests were used to calculate a Cognitive Impairment Index. The results show that a high nu mber of (juxta)cortical lesions is detected with thin slice FLAIR (30% of a ll lesions seen). This percentage was nor superior to spin-echo, reflecting the thin slice thickness (3 mm) we used. The lesions detected with FLAIR w ere to a certain degree different ones than the lesions detected with the o ther techniques. While the number of non-cortical lesions correlated with t he expanded disability status scale (r=0.32, P=0.045), the number of (juxta )cortical lesions detected with the FLAIR showed a correlation (r=0.34, P=0 .035) with the Cognitive impairment Index. Our study underlines the high nu mber of (juxta)cortical lesions in MS and the value of thin slice FLAIR seq uence to detect such lesions with MRI. It also stresses the importance of ( juxta)cortical lesions on determining neuropsychological impairment.