Attention deficits in Japanese multiple sclerosis patients with minor brain lesion loads

Akitoshi Takeda^1,3, Masashi Nakajima¹, Mutsutaka Kobayakawa¹, Natsuko Tsuruya¹, Shin-ichi Koyama^1,2, Takami Miki³, Mitsuru Kawamura^1,4
1Department of Neurology, Showa University School of Medicine, Tokyo, Japan; ²Faculty of Engineering, Chiba University, Chiba, Japan; ³Department of Geriatric Medicine and Neurology, Osaka City University Graduate School of Medicine, Osaka, Japan; ⁴Core Research for Evolutional Science and Technology (CREST), Japan Science and Technology Agency (JST), Saitama, Japan

Background: To investigate whether Japanese multiple sclerosis (MS) patients with minor brain lesion loads have attention deficits and brain atrophy, and to correlate their circumstance.
Method: Twenty-one Japanese patients with relapsing-remitting MS were included in this study. Attention deficits were evaluated using Clinical Assessment for Attention (CAT) standardized according to age groups. Lesion load in the brain was assessed by tallying the total volume of plaques visible on brain magnetic resonance imaging (MRI). The width of the third ventricle and the bicaudate ratio were measured.
Results: The completion time for the visual cancellation tasks and/or the reaction times for the continuous performance test were prolonged in 14 patients (66.7%). The accuracy of responses was preserved throughout the CAT. Deviation from the normal value was not exaggerated based on the increasing difficulty of the task. The total volume of plaques on brain MRI was small. The width of the third ventricle was significantly increased in patients with MS when compared to controls, but was not correlated with the low performance on the CAT.
Conclusions: Japanese MS patients with minor brain lesion loads frequently had attention deficits characterized by slowness of automatic information processing, but controlled processing that requires working memory demands was spared.

Keywords: attention, cognitive function, magnetic resonance imaging, multiple sclerosis