SUSTAINED COGNITIVE DECLINE IN MULTIPLE SCLEROSIS: INVESTIGATING THE ROLE OF WHITE MATTER LESION LOAD USING AN AI-DRIVEN BRAIN IMAGING APPROACH. - 2025
artificial intelligence; cognitive impairment; multiple sclerosis; neuroimaging; white matter lesion load; Humans; Male; Female; Middle Aged; Magnetic Resonance Imaging/methods; Adult; Disease Progression; Brain/diagnostic imaging; Brain/pathology; Multiple Sclerosis/diagnostic imaging; Multiple Sclerosis/complications; Multiple Sclerosis/pathology; White Matter/diagnostic imaging; White Matter/pathology; Cognitive Dysfunction/diagnostic imaging; Cognitive Dysfunction/etiology; Cognitive Dysfunction/pathology; Artificial Intelligence; Brain; Cognitive Dysfunction; Magnetic Resonance Imaging; White Matter; Psychiatry and Mental Health
Abstract :
[en] [en] BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system, where cognitive impairment can occur even without physical disability. The underlying mechanisms remain poorly understood. This study investigates the role of white matter lesion load (WMLL) in sustained cognitive decline (SCD) in a real-life MS cohort, using an artificial intelligence(AI)-based brain imaging approach.
METHODS: Patients from the CHU Helora MS database with ≥3 SDMT assessments and serial brain MRIs were included. SCD was defined as a ≥4-point or ≥10% SDMT drop, confirmed 6 months later. Patients were stratified into two groups: those with SCD (COG) and those without (N-COG). WMLL was measured using a AI-based model that provides segmentation masks. Lesion volume was calculated by multiplying segmented voxels by voxel size.
RESULTS: Of 109 eligible patients, 43 met inclusion criteria. Seven showed SCD; 36 did not. Imaging data were available for 5 COG and 21 N-COG patients. There was no significant difference in WMLL or its progression between patients with and without SCD. Fewer than half of the patients in the COG group showed an increase in WMLL over time, and those who did were older than the group average. WMLL changes were not a reliable marker of SCD. Consistent with previous findings, the COG group included more males, and disease control appeared more challenging. Vascular pathology may be misclassified by segmentation algorithms, which partially explain why the two patients with WMLL progression were older. Gray matter was not assessed, though it may play a key role in this phenomenon.
CONCLUSION: SCD did not consistently correlate with WMLL progression. Affected patients were predominantly male, consistent with a more aggressive disease course. WMLL may also be influenced by age-related factors. Alternative imaging biomarkers are needed to explain SCD in MS.
Disciplines :
Neurology
Author, co-author :
Tota, Vito; Department of Neurology, Centres Hospitaliers Universitaires HELORA, Mons, Belgium
Mehuys, Astrid; Department of Neuroscience, Research Institute for Health Science and Technology, University of Mons, Mons, Belgium
Vansnick, Tanguy; Computer Science, Software and Artificial Intelligence Unit (ILIA), University of Mons, Mons, Belgium
Amel, Otmane; Department of Computer Science, University of Tiaret, Tiaret, Algeria
Chahbar, Fatma; Department of Computer Science, University of Tiaret, Tiaret, Algeria ; Laboratoire de Génie Energétique et Génie Informatique (L2GEGI), University of Tiaret, Tiaret, Algeria
Mahmoudi, Lamia; Department of Computer Science, University of Tiaret, Tiaret, Algeria ; Laboratoire de Génie Energétique et Génie Informatique (L2GEGI), University of Tiaret, Tiaret, Algeria
Mahmoudi, Sidi Ahmed; IMT Nord Europe, Institut Mines-Télécom, Center for Digital Systems, Lille, France
Briganti, Giovanni ; Université de Liège - ULiège > Département des sciences cliniques > Santé digitale ; Department of Computational Medicine and Neuropsychiatry, Faculty of Medicine, University of Mons, Mons, Belgium
Ris, Laurence; Department of Computational Medicine and Neuropsychiatry, Faculty of Medicine, University of Mons, Mons, Belgium
Mahmoudi, Said; Department of Computational Medicine and Neuropsychiatry, Faculty of Medicine, University of Mons, Mons, Belgium
Language :
English
Title :
SUSTAINED COGNITIVE DECLINE IN MULTIPLE SCLEROSIS: INVESTIGATING THE ROLE OF WHITE MATTER LESION LOAD USING AN AI-DRIVEN BRAIN IMAGING APPROACH.
Publication date :
September 2025
Journal title :
Psychiatria Danubina
ISSN :
0353-5053
Publisher :
Medicinska Naklada Zagreb, Croatia
Volume :
37
Issue :
Suppl 1
Pages :
321 - 329
Peer reviewed :
Peer Reviewed verified by ORBi
Funding text :
This publication acknowledges the financial support of the European Union and Wallonia through the FEDER program for the project titled \u201CMedReSyst_UMONS_AI for Brain\u201D. The funding sources had no role in the design ofthe study, data collection, analysis, interpretation of results, writing ofthe manuscript, or decision to publish.
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