الفهرس 
Introduction
Multiple SclerosisOnly 14 pages are availabe for public view
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Abstract
Background:Multiple sclerosis (MS) is a chronic inflammatory immune-mediated disease of CNSwhichis characterized by multifocal progressive demyelination and neurodegeneration of the grey and white matter. Indeed, cortical grey matter lesions turn out to be rather specific for MS so that the last 2017 revisions of McDonald criteria recommend their incorporation into diagnostic criteria to demonstrate dissemination in space.The grey matter pathology plays a major role in cognitive impairment in MS patients.
Neurocognitive tests such as Montreal cognitive assessment (MoCA) and symbol digit modality test (SDMT) are found to be quickly and easily used to assess cognitive status in MS patient. Double inversion recovery (DIR), phase-sensitive inversion recovery are used to increase the detection rate of CLs. Double inversion recovery (DIR) is considered to be the commonest pulse sequence used for cortical lesion detection.
Patients and Methods:Our study was carried out on 30patients, 17 males (56.7%)and 13 females (43.3%). Physical disability was assessed by expanded disability status scale (EDSS). The cognitive status was assessed by neurocognitive tests: MoCA and SDMT. MRI brain (double inversion recovery (DIR) sequence) were done to all patient and lesions detected by 2 observers.
Results: . There were excellent inter-observer agreement of number, subtypes and both curvilinear and oval shapes of the cortical lesions and of total lesion load, indicating reliability and accuracy of DIR sequence. We studied correlation between cognitive status and some MRI measures as (cortical grey matter lesions and total lesion load) in MS patients These parameters were well correlated with clinical score tests for cognitive assessment.
Conclusion:According to these data, we can conclude that cognitive impairment in MS patients was highly correlated with number, shape and pattern of cortical lesions in addition to the total lesion volumes measured in DIR sequence.
Key words:grey matter; cognitive impairment; Double inversion recovery (DIR) ; cortical lesions