http://link.springer.de/link/service/journals/00415/bibs/1248012/12481049.htm
Journal of Neurology
Volume 248 Issue 12 (2001) pp 1049-1055
M. Sailer (1), H. J. Heinze (1),
I. Tendolkar (1), U. Decker (1), O. Kreye (1), U. v. Rolbicki (1), T. F.
Münte (2)
(1) Dept. of Neurology II, Otto-von-Guericke-University,
Magdeburg, Leipzigerstr. 44, 39120 Magdeburg, Germany, Tel.: +49-3 91/6
71 50 31, Fax: +49-3 91/6 71 50 32, E-mail: michael.sailer@medizin.uni-magdeburg.de
(2) Department of Neuropsychology,
Otto-von-Guericke-University, Magdeburg, Lennéstr. 6, 39112 Magdeburg,
Germany
Abstract
Neurocognitive involvement in multiple
sclerosis (MS) is heterogeneous with some authors suggesting a frontal
pattern in patients with predominantly frontal lesions.
To assess the relationship between
the distribution of lesions and two cognitive components (visual N2, auditory
P3a) of the event-related brain potential (ERP) receiving contributions
from frontal lobe structures, we performed a combined ERP and magnetic
resonance imaging (MRI) study.
Thirty-four MS patients were assigned
to "low lesion volume, (LLV)"(n = 12), "high lesion volume, (HLV)" (n =
12) and "frontal lesion volume, (FLV)" (n = 10) groups according to lesion
volume and distribution on T2-weighted MRI-scans of the brain.
ERPs in visual and auditory classification
tasks as well as neuropsychological tests were carried out in patients
and control subjects (n = 15).
The index for automatic feature registration,
the N2 component with its mainly frontal contribution in the visual task,
was significantly reduced in amplitude in the FLV and HLV groups (both
p < 0.01 vs. controls).
Moreover its amplitude correlated
with lesion volume (r=0.64, p < 0.001). In contrast neither P3a nor
P3b subcomponents with a multiple generator nature in the auditory task
varied systematically with lesion volume or distribution.
Total lesion volume rather than predominant
lesion arrangement appears to be the most important factor in neurocognitive
changes in MS.
This is most consistent with the
view that MS lesions lead to partial disconnections within widespread cortical
networks which in turn produce a pattern of neuropsychological deficits
that reflect total lesion load more than lesion distribution.
© Steinkopff Verlag 2001