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Multiple Sclerosis International
Volume 2013, Article ID 838719, 9 pages
Clinical Study

Quantitative MRI Demonstrates Abnormality of the Fornix and Cingulum in Multiple Sclerosis

1Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, MD 21287, USA
2Translational Neuroradiology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive, MSC 14001, Building 10/5C103, Bethesda, MD 20892, USA

Received 15 July 2012; Revised 18 December 2012; Accepted 1 January 2013

Academic Editor: Iris-Katharina Penner

Copyright © 2013 Stephanie B. Syc et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To characterize MR signal changes associated with tissue damage in the fornix and cingulum in multiple sclerosis (MS) using quantitative MRI measures and to determine associations with cognitive dysfunction. Background. The fornix and cingulum are white-matter bundles that carry information related to cognition. While cognitive dysfunction is reported in 40–60% of MS patients, the neuroanatomical correlates of cognitive impairment remain incompletely understood. Methods. The cingulum, pillars of the fornix, and corticospinal tract were segmented by fiber tracking via diffusion tensor imaging. Average tract-specific fractional anisotropy (FA), mean diffusivity (MD), and magnetization transfer ratio (MTR) were compared in MS cases and healthy volunteers. Associations with clinical measures and neuropsychological tests were derived by multivariate linear regression. Results. Fornix FA ( ) and MTR ( ) were decreased, and fornix MD ( ) and cingulum MD ( ) increased, in MS cases ( ) relative to healthy volunteers ( ) after adjustment for age and sex. Lower fornix FA and MTR, and higher fornix MD and , were correlated with lower PASAT-3 scores, but not with slower 25FTW times. Lower PASAT-3 scores were associated with lower cingulum FA and higher MD and . Conclusions. Cognitive dysfunction in MS may involve damage to a widespread network of brain structures, including white-matter pathways within the limbic system.