Pain, cognition and quality of life associate with structural measures of brain volume loss in multiple sclerosis

Issue title: From Theory to Practice: Engagement in Neurorehabilitation

Guest editors: Megan Danzl and Nicole Etter

Article type: Research Article

Authors: Fritz, Nora E.^{a; b; c; *} | Roy, Snehashis^d | Keller, Jennifer^b | Prince, Jerry^e | Calabresi, Peter A.^f | Zackowski, Kathleen M.^{b; c; f}

Affiliations: [a] Department of Physical Therapy, Wayne State University, Detroit, MI, USA | [b] Motion Analysis Laboratory, Kennedy Krieger Institute, Baltimore, MD, USA | [c] Johns Hopkins School of Medicine, Department of Physical Medicine & Rehabilitation, Baltimore, MD, USA | [d] Center for Neuroscience and Regenerative Medicine, Henry Jackson Foundation, Bethesda, MD, USA | [e] Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA | [f] Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA

Correspondence: [*] Address for correspondence: Nora Fritz, Wayne StateUniversity, 259 Mack Avenue, #2324, Detroit, MI 48201, USA. Tel.: +1313 577 1096; Fax: +1313 577 8685; E-mail: [email protected].

Abstract: BACKGROUND: Multiple sclerosis (MS) is characterized by physical and mental impairments that often result in pain and reduced quality of life. OBJECTIVE: To understand the relationship of pain, quality of life, and cognition to structural measures of brain volume. METHODS: Behavioral measures were assessed in a single session using standardized questionnaires and rating scales. Brain volume measures were assessed with structural magnetic resonance imaging (MRI). RESULTS: Twenty-nine individuals with relapsing-remitting MS and 29 age-matched controls participated in this study. Pain, quality of life, and cognition were significantly interrelated. Higher fluid attenuation inversion recovery weighted lesion volume was significantly associated with increased reports of pain (p = 0.01), lower physical quality of life (p < 0.0001), and lower cognitive performance (p = 0.001) in our cohort. CONCLUSIONS: Assessment of pain and quality of life along with structural MRI highlights the importance of understanding structure-function relationships in MS and suggests that therapists should not only evaluate individuals for cognition and quality of life, but should consider rehabilitation goals that target these areas.

Keywords: Multiple Sclerosis, quality of life, pain, cognition, MRI, brain volume, lesion volume

DOI: 10.3233/NRE-161384

Journal: NeuroRehabilitation, vol. 39, no. 4, pp. 535-544, 2016