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A well-known small subgroup of patients with so-called benign multiple sclerosis (BMS) do not develop substantial locomotor disability during long-term follow-up. Nonetheless, cognitive dysfunction can occur in patients with BMS. These authors used diffusion tensor (DT) MRI techniques to prospectively examine the extent of brain tissue damage and correlated the findings with measures of cognitive disability in 62 patients with BMS (disease duration, ≥15 years; EDSS score, ≤3.0). Thirty-six patients with secondary progressive MS (SPMS) and 19 healthy controls also underwent DT MRI.
Of the 62 patients with BMS, 12 (19%) had cognitive impairments. These 12 had severe structural brain disease that resembled that of the SPMS patients as detected …