Journal Article
Cognitive functioning in multiple sclerosis with focus on brainstem volume
Eline Van Doninck; Anna-Victoria De Keersmaecker; Marie D’hooghe; Bart Van Wijmeersch; Gaetano Perrotta; Souraya El Sankari; Vincent van Pesch; Dominique Dive; Miguel D’Haeseleer; Guy Laureys; Barbara Willekens; Lander Willem; Veronica Popescu
Acta Neurologica Belgica · Vol. 126, Issue 1 · pp. 197-206 · 2026
Abstract
Background The brainstem is a vital component of the cerebro-cerebellar network underlying cognition, however it remains unclear whether brainstem volumes are associated with cognitive functioning in MS. Objective Investigate the relationship between brainstem volumes and cognitive impairment in MS, as assessed by the BICAMS battery (processing speed, verbal and visuospatial memory). Methods We analyzed data from the VOLUMS (Volumetry in MS) study, including 143 MS patients. Magnetic resonance imaging (1.5/3.0 T, 3DT1-weighted images) was used for brain volumetrics and brainstem lesion counts. Cognitive data were collected using the “Brief International Assessment of Cognition for Multiple Sclerosis” (BICAMS). Correlation and stepwise logistic regression explored associations between brain volumes and cognitive performance. In a subset of 35 patients with 3-year follow-up, longitudinal changes in brain volumes and cognition were also assessed. Results Cognitive impairment (≥ 2 standard deviations below predicted scores on at least one test) was present in 30.1% of participants. No significant correlations were found between brainstem volume and cognitive scores. Hippocampus (p = .046), thalamus (p = .024), cortex (p Conclusion While no link was found between brainstem volumes and cognitive impairment, this analysis underscores the importance of considering various brain structures in understanding cognitive impairment in MS.