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Steven J. Huber, PhD; George W. Paulson, MD; Edwin C. Shuttleworth, MD; Donald Chakeres, MD; Lawrence E. Clapp; Ann Pakalnis, MD; Kenneth Weiss, MD; Kottil Rammohan, MD

Arch Neurol. 1987;44(7):732-736.

Abstract
• Thirty-two patients with clinically definite multiple sclerosis were evaluated with neuropsychological procedures and magnetic resonance imaging (MRI). Neuropsychological evaluation included assessment of language, memory, cognition, visuospatial skills, and depression. Significant impairment in any three areas, compatible with diagnosis of a dementia syndrome, was observed in 28% of these patients, and lesser or no cognitive impairment characterized the remaining patients. Magnetic resonance imaging was used to evaluate the number and distribution of lesions as well as the presence of cerebral atrophy and atrophy of specific anatomic structures such as the corpus callosum. Results suggest that neither the number of lesions, the distribution of lesions, nor the extent of generalized cerebral atrophy was significantly greater in demented compared with non-demented patients. The primary finding was that atrophy of the corpus callosum was significantly more extensive on MRI scans in demented patients. Although the callosum itself may not be implicated directly in the pathogenesis of dementia, the presence of callosal atrophy on MRI scans should alert the physician to the possible occurrence of dementia in patients with multiple sclerosis.

Author Affiliations
From the Departments of Neurology (Drs Huber, Paulson, Shuttleworth, Pakalnis, and Rammohan and Mr Clapp) and Radiology (Drs Chakeres and Weiss), The Ohio State University College of Medicine, Columbus.

Footnotes
Accepted for publication March 20, 1987.

Reprint requests to Department of Neurology, The Ohio State University College of Medicine, 439 Means Hall, 1655 Upham Dr, Columbus, OH 43210 (Dr Huber).

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