Lesional and non-lesional cortical integrity in cognitive networks are linked to cognitive impairment in multiple sclerosis.

Cognitive functioning in people with multiple sclerosis (MS) is strongly related to cortical lesions (CLs), although the severity of demyelination remains difficult to assess in-vivo. In addition, how the pathological microstructural changes in normal-appearing gray matter relate to cognition also remains unclear. This study assessed how microstructural integrity (based on diffusion MRI) in CLs and normal-appearing cortex relates to cognition in MS. Microstructural integrity changes were most evident in cognitively-impaired MS, especially in the normal-appearing cortex. Regionally, damage was especially related to cognition within cognitive functional networks such as the ventral attention network.