Objective: Multiple sclerosis (MS) is the most common neurodegenerative disease among young adults, of which 40-70% of the patients suffer from cognitive impairment. Currently, there is no...Show moreObjective: Multiple sclerosis (MS) is the most common neurodegenerative disease among young adults, of which 40-70% of the patients suffer from cognitive impairment. Currently, there is no biomarker predicting the cognitive status of MS patients. This study performed a principal component analysis in order to find a disease pattern that can aid in the differentiation of cognitive impairment in MS. Methods: A principal component analysis (PCA) was performed to create a disease pattern based on differences in whole-brain voxel intensities of conventional MRI sequences (T1, T2, and T2- FLAIR) and magnetization transfer (MT)-based MRI of 15 cognitively preserved MS patients (MSCP), 15 impaired patients (MS-CI) and 15 controls. A leave-one-out approach was used to validate the disease patterns between different cognitive performance statuses. Results: None of the conventional MRI sequences nor MT-based MRI were able to find a significant disease pattern for separating MS patients on cognitive status. The frontal cortex, periventricular zone, longitudinal fasciculus, thalamus and brainstem were more severely affected in cognitive impaired MS patients, although significance was not reached. Conclusion: Although the brain patterns created with both conventional MRI sequences and MTbased MRI sequences for evaluating cognitive performance in MS were not significant, the PCA is still a promising technique, when a larger sample size can be included.Show less