Evaluation of the relationship of social cognition with structural and functional connectivity in persons with multiple sclerosis

Objective: This study aims to assess the relationship between social cognition and general cognition, and neuroimaging data in multiple sclerosis (MS). Additionally, the relationship between social cognitive impairment and depression-anxiety, and physical disability was evaluated. Methods: In this study, 41 persons with MS (pwMS) and 28 healthy controls (HC) were enrolled. Participants underwent Brief International Cognitive Assessment for MS – BICAMS, Reading the Mind in the Eyes Test (RMET), Faux Pas Test, Facial Affect Recognition (FAR) test, Empathy Quotient (EQ), Hospital Anxiety and Depression Scale (HADS), 2 Minute Walk Test (2MWT), Nine-Hole Peg Test (9-HPT) for outcome measures. In addition, Timed 25-Foot Walk Test (T25wt) was applied in pwMS. All participants underwent 3 T, 3D T1 MRI. Groups were compared by the generalized linear model. Results: No statistically significant differences observed between MS and HC groups regarding age, gender, education level, and estimated total intracranial volume (ICV) (p> 0.005). Empathy quotient, depression-anxiety, upper and lower extremity function measurements between MS patients and healthy controls were compared, and it was observed that pwMS performed worse (p <0.005). While, impairment was found in %36.8 of pwMS in EQ and RMET, %21,1 of pwMS's FAR and Faux Pas tests were impaired. On the other hand, impairment was found %17,9 of the HC in EQ, RME, FAR Tests and %14,3 of HC was found impaired in Faux Pas Test.Impaired pwMS in each test and pwMS without impairment were compared in terms of cortical and subcortical brain volumes, and there were no significant differences observed in the RME and Faux Pas Test (p> 0.005). FAR test was found positively correlated with the left pericalcarine cortex thickness, and EQ test was detected positively correlated with left amygdala and left entorhinal cortex thickness (p <0.005). In regression analysis, left amygdala volume was the predictor of EQ performance, and it contributes to the differences observed between MS and HC. Conclusion: Patients' social cognition may be impaired on without general cognitive impairment, and social cognition is not directly related to depression and physical disability. Social cognitive performance in MS is correlated with atrophy of areas associated with social cognitive connectivity.