One aim of our study was to define the impact of Peg-IFN maintena

One aim of our study was to define the impact of Peg-IFN maintenance therapy on XAV-939 hepatic function

in patients with advanced, but compensated, chronic HCV. In three large clinical trials, maintenance therapy failed to slow disease progression or reduce clinical outcomes.22-24 In the HALT-C Trial, serum HCV RNA and ALT and hepatic inflammation were reduced by maintenance therapy.22 The latter effects could potentially reflect a reduction in hepatic injury, which might improve hepatic function or blood flow. However, in the current study, Peg-INF maintenance therapy failed to improve any of the serially performed QLFTs—a group of tests that evaluated a broad range of hepatic functions and blood flow. The lack of improvement in QLFTs in the current study provides additional evidence that maintenance therapy with low-dose Peg-IFN is GSK126 cost ineffective. Another major aim of our study was to evaluate the independent ability of QLFTs to predict future clinical outcomes. Our patient cohort was ideal for addressing this aim because all had advanced fibrosis, all were at risk for future clinical outcome, and none had experienced previous decompensation. In follow-up, 24% of our cohort experienced a clinical outcome similar to the rate of clinical outcome observed in the HALT-C

Trial as a whole.22 Our results are likely representative of the whole HALT-C cohort, and the general population of, compensated patients with advanced chronic HCV. Because QLFTs monitor changes in hepatic metabolism and blood flow, changes common to all liver diseases, they could potentially be useful in monitoring patients with any liver disease. Despite a 48.5% prevalence of hepatic steatosis in our cohort, the relationships of CA Cls, shunt, and PHM to stages of hepatic fibrosis and cirrhosis are preserved and not altered by body mass index (BMI), hepatic steatosis, homeostasis model assessment (HOMA) score, hepatic inflammation, alcohol use, and smoking.19 In addition, SPECT liver-spleen scan has correlated with the severity of a variety of liver diseases.25-28 Progression of chronic

Lepirudin HCV is characterized pathologically by accumulation of fibrosis and physiologically by impairment of hepatic function and blood flow. In our study, we measured physiologic impairment using a battery of QLFTs. We previously demonstrated that these QLFTs predicted cirrhosis, stage of fibrosis, varices, and variceal size.19 Also, they identified the subgroup of patients with the most severe disease who failed to respond to antiviral therapy and tracked improvement in hepatic function after SVR.20 In the current study, QLFTs identified patients with the greatest hepatic impairment who developed clinical outcomes. We defined cutoffs for QLFTs that predicted risk for future clinical decompensation over a median duration of follow-up of 5.5 years.

One aim of our study was to define the impact of Peg-IFN maintena

One aim of our study was to define the impact of Peg-IFN maintenance therapy on www.selleckchem.com/products/a-769662.html hepatic function

in patients with advanced, but compensated, chronic HCV. In three large clinical trials, maintenance therapy failed to slow disease progression or reduce clinical outcomes.22-24 In the HALT-C Trial, serum HCV RNA and ALT and hepatic inflammation were reduced by maintenance therapy.22 The latter effects could potentially reflect a reduction in hepatic injury, which might improve hepatic function or blood flow. However, in the current study, Peg-INF maintenance therapy failed to improve any of the serially performed QLFTs—a group of tests that evaluated a broad range of hepatic functions and blood flow. The lack of improvement in QLFTs in the current study provides additional evidence that maintenance therapy with low-dose Peg-IFN is AP24534 datasheet ineffective. Another major aim of our study was to evaluate the independent ability of QLFTs to predict future clinical outcomes. Our patient cohort was ideal for addressing this aim because all had advanced fibrosis, all were at risk for future clinical outcome, and none had experienced previous decompensation. In follow-up, 24% of our cohort experienced a clinical outcome similar to the rate of clinical outcome observed in the HALT-C

Trial as a whole.22 Our results are likely representative of the whole HALT-C cohort, and the general population of, compensated patients with advanced chronic HCV. Because QLFTs monitor changes in hepatic metabolism and blood flow, changes common to all liver diseases, they could potentially be useful in monitoring patients with any liver disease. Despite a 48.5% prevalence of hepatic steatosis in our cohort, the relationships of CA Cls, shunt, and PHM to stages of hepatic fibrosis and cirrhosis are preserved and not altered by body mass index (BMI), hepatic steatosis, homeostasis model assessment (HOMA) score, hepatic inflammation, alcohol use, and smoking.19 In addition, SPECT liver-spleen scan has correlated with the severity of a variety of liver diseases.25-28 Progression of chronic

all HCV is characterized pathologically by accumulation of fibrosis and physiologically by impairment of hepatic function and blood flow. In our study, we measured physiologic impairment using a battery of QLFTs. We previously demonstrated that these QLFTs predicted cirrhosis, stage of fibrosis, varices, and variceal size.19 Also, they identified the subgroup of patients with the most severe disease who failed to respond to antiviral therapy and tracked improvement in hepatic function after SVR.20 In the current study, QLFTs identified patients with the greatest hepatic impairment who developed clinical outcomes. We defined cutoffs for QLFTs that predicted risk for future clinical decompensation over a median duration of follow-up of 5.5 years.

Methods: We performed a meta-analysis using MEDLINE

Methods: We performed a meta-analysis using MEDLINE Vadimezan mw and EMBASE search and reviews of article bibliographies and abstracts from recent scientific meetings.

Criteria for acute HCV was HCV-RNA positivity or anti-HCV seroconversion within six months since last negative tests, except one where twelve months was used. Included studies had at least ten adult HIV+/acute HCV patients who initiated P/R for 24 to 48 weeks. Data was insufficient for separate analysis for SVR by treatment duration. We excluded retreated patients. Random effects model was used for meta-analysis, with results expressed as pooled probability. Results: Twelve studies met the inclusion criteria and were included in the current analysis. Pooled Selleck Fulvestrant SVR was 71.4% (323/450) (Figure). RVR was 47.4% (93/196), and EVR was 82.8% (221/283). Probability of SVR was 93.1% (77/82) in patients who obtained RVR, 85.9% (150/168) if EVR+. Conclusion: P/R for 24 to 48 weeks is effective in the treatment of acute HCV in HIV

co-infected patients with SVR over 70% and over 90% in those with RVR and close to 90% for those with EVR. P/R can be a reasonable option for patients who do not have access to newer but more expensive anti-HCV therapy. SVR for all studies and pooled. Disclosures: Walid S. Ayoub – Advisory Committees or Review Panels: Gilead Mindie H. Nguyen – Advisory Committees or Review Panels: Bristol-Myers Squibb, Bayer AG, Thalidomide Gilead, Novartis, Onyx; Consulting: Gilead Sciences, Inc.; Grant/Research Support: Gilead Sciences, Inc., Bristol-Myers Squibb, Novartis Pharmaceuticals, Roche Pharma AG, Idenix, Hologic, ISIS The following people have nothing to disclose: Bing Zhang, Benjamin Yip, Nghia H. Nguyen, Brittany E. Yee, Glen A. Lutchman Background and Aims: A single nucleotide polymorphism (SNP) rs368234815 (TT/G) within a newly discovered type III interferon, interferon lambda 4 (IFNL4) located upstream of

interleukin-28B (IL-28B), have been reported to strongly affect anti-viral therapy for chronic hepatitis C virus (HCV) infection in African and Caucasian populations compared to previously reported IL-28B SNPs, rs12979860 and rs8099917. This study was aimed to compare the predictability of IFNL4/IL-28B polymorphisms for viral response among HCV patients in Japanese population. Methods: We analyzed the haplotype structure of IFNL4/IL-28B consisting of three SNPs (rs12979860, rs368234815, and rs8099917) in 4,630 Japanese chronic hepatitis C patients and 1,122 healthy controls, and then compared their impact on treatment outcome to pegylated-in-terferon (PEG-IFN) plus ribavirin (RBV) combined therapy in 903 HCV-1b infected patients. Next, associations between early viral response and genotypes were compared among the SNPs in 479 patients infected with HCV genotype 1b.

By middle age, most HHT patients will demonstrate marked telangie

By middle age, most HHT patients will demonstrate marked telangiectasia on their lips, fingertips and buccal mucosa. In addition, the majority of HHT patients will be

affected by AVMs in at least one site, particularly in the pulmonary (up to 50%), Doxorubicin solubility dmso hepatic (20–30%) and cerebral (10%) circulations. The HHT disease spectrum has recently expanded further to encompass pulmonary hypertension (two forms predominate in HHT), juvenile polyposis, a prothrombotic state and potential immune dysfunction, each affecting a relatively small proportion of HHT-affected individuals. HHT presentation patterns are highly variable even within families. Major complications of HHT include: severe anaemia from chronic nasal and GI haemorrhage; stroke (ischaemic and brain abscess from pulmonary AVMs; haemorrhagic from cerebral AVMs); deep venous thromboses; in rarer cases, symptomatic liver disease requiring liver transplantation; severe pulmonary hypertension; pregnancy-related death; and spinovascular accidents. Overall, however, life expectancy is near normal, particularly for older individuals. Most HHT-affected individuals remain unaware that their symptoms or unusual medical conditions might be connected by a multisystem vascular disorder that is often poorly recognized by doctors. Three HHT disease-causing genes have been identified to date: HHT type 1 results

from mutations in ENG encoding endoglin; HHT type 2 results from mutations in ACVRL1 encoding ALK1 and HHT in association with juvenile polyposis (JPHT) results from mutations in MADH4. There are at least two further unidentified genes that can cause classical this website HHT. ENG and ACVRL1 genes are the most frequently mutated, and genetic testing is available. There PJ34 HCl are some important genotype–phenotype correlations. Pulmonary and cerebral AVMs are more common in HHT1. Hepatic AVMs and two forms of pulmonary hypertension are more common in HHT2. However, the frequency and severity of nose and GI bleeds have

not been shown to differ between genotypes. Several helpful review articles have been published in recent years, guiding management practice. In 2009, the International HHT Guidelines were published [33]. These resulted from systematic assessments of the HHT evidence base up to October 2006 and provided 33 recommendations. While these are a very helpful starting point for the field, it is important to recognize that 30 of the 33 recommendations were based on the lowest evidence level (level 3); three had low levels of agreement, and several have already been superseded by other publications, such as the American Heart Association’s statement on antibiotic prophylaxis [34]. A 2009 reference [35] incorporated an analysis of 2007–2009 publications, with further important subsequently published data including a randomized controlled clinical trial demonstrating efficacy of tamoxifen, and highly publicized reports on anti-angiogenesis agents such as bevazicimub.

Similarly, the dispersal rate was greater among male lynx than am

Similarly, the dispersal rate was greater among male lynx than among female lynx, with

100% of the males dispersing compared with 65% of the females dispersing. This study showed that dispersal patterns by lynx in Scandinavia were male biased, with (1) male lynx dispersing farther and more frequently than female lynx and (2) female lynx often settling near their natal areas. These patterns, in turn, will have large impact on gene flow and the ability by lynx to colonize new and formerly occupied areas. “
“Information on the movement behaviour and MI-503 habitat use by non-native invasive African catfish Clarias gariepinus is crucial in understanding and possibly mitigating its potential impacts. The aim of this study was to examine catfish movement and habitat selection within an invaded impoundment

in the Eastern Cape, South Africa. Acoustic telemetry data for 10 tagged catfish were analyzed to identify spatial patterns in home ranges and seasonal changes learn more in habitat associations. Long-distance movements were observed for most catfish from common central release point, whereas short-distance movements defined their home ranges and utilization distributions that were categorized as localized within single or multiple habitats. Habitat selection was non-random with most catfish utilizing the shallow river mouth and upper section of the reservoir that were dominated by a rocky substratum interspersed with submerged trees. These localities were likely to be preferred for spawning and/or

feeding. Utilization Niclosamide of these habitats by catfish is likely to be associated with probable impact due to predation and interference competition for feeding and breeding grounds with other species. Although most catfish maintained their home ranges throughout the study, seasonal shifts in habitat use, which was reflected by the utilization of deep and silt-dominated habitats, were also observed for some catfish. Non-random habitat use and homing behaviour within single and multiple habitats by non-native sharptooth catfish suggests that its impact within the invaded habitats may be associated with particular habitats both at broad spatial and temporal scales. Protection of habitats from catfish invasion should be considered as a management option to conserve native biota. “
“CEBC-CNRS UPR 1934, Villiers en Bois, France Both theoretical and empirical investigations suggest that predation risk and availability of resources interact as trade-offs to produce patterns of predation-sensitive foraging. Such interactions have been explored intensely in terrestrial predator–prey systems where both nocturnal prey and predators adjust their activity and foraging behaviour to levels of moonlight. In the case of prey, higher levels of moonlight increase predation risks, and thus prey display lower levels of activity and/or shifts in their use of microhabitat during full moon nights.

Our research group has been investigating the T-cell-driven immun

Our research group has been investigating the T-cell-driven immune response to infused FVIII with the aim of identifying additional T-cell epitopes. One goal of these studies is to facilitate the ‘rational design’ of less immunogenic FVIII proteins. Herein, some novel T-cell assays that

our laboratory has adopted to assess FVIII immunogenicity are described. In addition, detailed phenotypes of FVIII-specific T cells are explored for possible clues as to tolerogenic mechanisms that guide clinical response to ITI. The MHC class II molecule binds to peptides ~11–20 amino acids in length, with binding determined by four pockets in the MHC groove. Binding motifs for many common MHC class II molecules have been identified [29]. An individual’s HLA class PD0332991 supplier II type determines whether no peptides or some specific peptides are presented on the surface of the MHC class II receptor. At present, the number and type of FVIII

peptides recognized and presented on a class II molecule in patients with haemophilia is an area of active research. Recombinant MHC class II molecules that bind FVIII-derived peptides are proving useful in the characterization of T-cell responses to FVIII [27]. MHC class II-peptide complexes are biotinylated at a specific site and streptavidin is used to cross-link the soluble molecules to form tetramers [30]. These fluorescently labelled molecules are able to detect antigen-specific CD4+ T cells by binding to a T-cell receptor capable of recognizing the MHC class II-peptide complex [30]. Midostaurin datasheet For several years our group has been investigating the number and characteristics of T-cell epitopes in haemophilia A patients with inhibitors. As FVIII is a large protein with many peptides, initial

studies have employed a systematic strategy known as Tetramer Guided Epitope Mapping (TGEM) (Fig. 6) [31]. In this protocol, soluble extracellular domains of MHC molecules are loaded with overlapping FVIII peptides and divided into pools each having 5 to 10 peptides. These pooled-peptide tetramers are used as reagents to analyse patient-derived CD4+ selleck cells previously stimulated with FVIII. The pool(s) with positive tetramer staining are identified by flow cytometry, with the tetramer indicated on the y-axis and CD4+ cells on the x axis. Peptides from a tetramer-positive pool are then loaded individually onto MHC molecules and the analyses are repeated in a process known as decoding. Decoding results (typically one, occasionally two) that resemble the original pooled result identify the specific peptide/s containing the epitope. T cells positive for tetramer staining can be sorted by flow cytometry, thus providing a rapid means of isolating and/or cloning these T cells. TGEM has been used to identify T-cell epitopes in patients with mild haemophilia A. An early study involved two brothers who had the same missense substitution FVIII-A2201P and shared the DRB1*01:01 HLA allele [32, 33].

Eighteen patients were given a reduction dose of ribavirin that d

Eighteen patients were given a reduction dose of ribavirin that decreased by one tablet per day compared to the standard group (reduction group). Results:  Of the 33 study patients, no patient stopped the treatment due to treatment-related adverse Saracatinib clinical trial events. The dose of IFN-β was reduced in three patients: Two patients belonged to the standard group and one patient belonged to the reduction group. The dose of ribavirin was reduced in 11 patients during combination therapy: nine patients belonged to the standard group and two patients belonged to the reduction group. The sustained virological

response (SVR) was 72.2% (13/18) in the reduction group and 80.0% (12/15) in the standard group. There was no significant difference in SVR rate between Selleck LBH589 the reduction and standard groups (P = 0.699). Conclusion:  The reduction therapy of IFN-β and ribavirin in elderly chronic hepatitis C patients with genotype 2 and high virus load is one selection of treatment. “
“Background and Aims:  Barrett’s esophagus (BE) is reported to be infrequent in Asians, with no data from India regarding its prevalence and risk factors. We investigated the frequency and risk factors of columnar mucosa with or without specialized intestinal metaplasia (SIM) in Indian patients with gastroesophageal reflux disease (GERD). Methods:  A total of 278 GERD patients over 2 years underwent

gastroscopy and completed a questionnaire fantofarone for possible BE risk factors. Patients with columnar mucosa on endoscopy underwent four-quadrant biopsy; BE was histologically defined as columnar mucosa with or without SIM. Patients without columnar mucosa at endoscopy were considered as controls and compared to patients with BE and those with SIM. Results:  Forty-six patients with GERD had columnar mucosa on histology (16.54%); 25 (8.99%) of these had SIM. The risk factors for BE were the presence of hiatus hernia (odds ratio [OR]: 3.14;

95% confidence interval [CI]: 1.2–8.17) and a history of eructation (OR: 2.28; CI: 1.11–4.66). The risk factors for SIM were age ≥ 45 years (OR: 2.63; CI: 1.03–6.71), hiatus hernia (OR: 3.95; CI: 1.24–12.56), and a history of eructation (OR: 3.41; CI: 1.19–9.78). Sex, severity of symptoms, dietary factors, tobacco or alcohol use, and body mass index were not associated with BE. The median circumferential segment length was 2 (1–10) cm, and the maximal length was 3 (2–11) cm in both groups. Conclusion:  BE is not an uncommon finding among Indian GERD patients. Age ≥ 45 years, history of eructation, and the presence of hiatus hernia are associated with SIM. “
“Prednisolone is a corticosteroid that has been used to treat inflammatory liver diseases such as autoimmune hepatitis and alcoholic hepatitis. However, the results have been controversial, and how prednisolone affects liver disease progression remains unknown.

This phase II/III open-label, multicentre study evaluated the eff

This phase II/III open-label, multicentre study evaluated the efficacy and safety of BIOSTATE®, a high purity plasma-derived double-virus inactivated FVIII/VWF concentrate, when used in non-surgical bleeds, surgical procedures and prophylactic therapy in VWD patients for whom desmopressin treatment was deemed ineffective, inadequate or contraindicated. Twenty three patients (7 type 1, 9 type 2 and 7 type 3; 12 male, 11 female), who received FVIII/VWF concentrate as part of their VWD management, were recruited prospectively between December 2004 and May 2007 from eight centres in Australia

and New Zealand. find protocol BIOSTATE dosing was based on pre-treatment FVIII:C and/or VWF:RCo plasma levels and a predetermined dosing guide. Haemostatic efficacy of BIOSTATE was rated as excellent or good for all major and minor surgery events, long-term prophylaxis, and for four of the six assessable non-surgical bleeding events. Blood transfusions were required by two major surgery patients as well as one patient with a non-surgical bleed. The median overall exposure to BIOSTATE across all groups

was 8 days, greater in the prophylactic group (range 53–197) compared with major surgery (3–24), minor surgery (1–8) and non-surgical bleeds Trichostatin A solubility dmso (1–10). BIOSTATE was shown to be efficacious and well tolerated when treating patients with VWD. This study also provides Cyclin-dependent kinase 3 important insights into dosing regimens with BIOSTATE and the role of monitoring therapy with FVIII:C and VWF:RCo. “
“Recurrent bleeding into joints initiates a sequence of events leading to a progressive joint damage in people with severe haemophilia. This is a continuous process during childhood and adolescence,

therefore joint abnormalities may be minimal on physical examination in very young children – even those receiving on-demand treatment. The aim of our study was to quantify the burden of arthropathy in Lithuanian patients who had been treated exclusively by on-demand substitution and compare their physical joint health with age-matched Danish patients who received prophylaxis from an early age. Boys, aged 4–17 years, with severe haemophilia and no signs of inhibitors were included in the study. Joint outcome based on the Haemophilia Joint Health Score (HJHS) was analysed in two different treatment groups and compared within the matched pairs. In total, 32 (16 in each treatment group) patients were enroled. A total of 192 joints were evaluated. Joint status according to treatment strategy was strikingly different: 27.4 for on-demand vs. 3.3 for prophylaxis (<0.001) group. Significance of the difference in joint status comparing different treatment strategies was equally strong both in younger (4–9 years) and older (10–17 years) patient groups: 2.2 vs. 12.5 (P = 0.0002) and 3.9 vs. 36.3 (P < 0.0001) respectively.

05) Conclusion: Using pulling away skills can reduce the negativ

05). Conclusion: Using pulling away skills can reduce the negative emotional Ribociclib order effects on clinical nurses’ psychology situation, improve the psychological

factor effect for solving problems, and then relieve the psychological pressure. It is worth being popularized and applied in heavy and trivial clinical nursing work. Key Word(s): 1. Pulling away skills; 2. pressure; 3. Relieving; 4. nurses; Presenting Author: KUANLOONG CHEONG Additional Authors: MOHARZUDI MOHAMED, RAMAN MUTHUKARUPPAN, JAYARAM MENON Corresponding Author: KUANLOONG CHEONG Affiliations: Ministry of Health, Malaysia Objective: Lymphangioma, a benign tumor usually found in the head, and neck regions, and rarely in the gastrointestinal tract

(GIT) [1–3], is mostly asymptomatic. When symptoms such as bleeding, or intussusceptions are present, resection of lymphangioma is necessary [4–7]. Traditionally, pedunculated lymphangiomas 2 cm or more in diameter are often BMS 354825 treated by surgical resection [8]. However, snaring using the ligating device has been reported as a safe and easy means to treat such lesion [9]. Herein, we report a case of GIT bleeding due to a colonic lymphangioma which was removed by endoscopic polypectomy with a ligating device. Methods: This is a case report of a colonic lymphangioma successfully treated by an endoscopic means. Results: A 71 year old Kadazan lady, Non-specific serine/threonine protein kinase with a history of Billroth II gastrectomy, presented with an 8-day history of melena and symptomatic anaemia, with

no abdominal pain or other alarming features. Examinations were unremarkable. Hemoglobin (Hb) was 6.5 g/dL. Oesophagogastroduodenoscopy revealed a small Forrest 3 ulcer at the anastomotic site. Colonoscopy found a huge pedunculated ascending colonic polyp (Fig. 1). After ligation with an Endoloop, the polyp was resected on the luminal side of the ligating device with a snare without complications. The polyp appeared as a soft 40x35x10 mm polyp. Cross-sectioning of the specimen showed intact colonic mucosa with well-spaced glands lined by benign epithelium and many dilated thin walled endothelial lining channels within the subserosa (Fig. 2). Hb was 8.5 g/dL and colonoscopy revealed no residual tumor 3 months later. Conclusion: The histologic diagnosis was colonic cystic lymphangioma. Key Word(s): 1. Lymphangioma; 2. Colon; 3.

The combination of 1H MRS data and 18F-FDG-PET imaging can enhanc

The combination of 1H MRS data and 18F-FDG-PET imaging can enhance detection of glioma progression. 1H MRS imaging was more accurate in low-grade gliomas and 18F-FDG-PET provided better accuracy in high-grade gliomas. J Neuroimaging 2012;22:184-190 “
“To determine acute intracranial hydrodynamic changes after subarachnoid hemorrhage (SAH) via phase-contrast MRI (PC-MRI) analysis of the CSF stroke volume in the aqueduct (SVaq) and the foramen magnum (SVfm). A prospective

PC-MRI study was performed on 34 SAH patients in the acute and late phase. Data on CSF flow and hemorrhage site were analyzed according to acute or chronic hydrocephalus (HC). In the acute phase, CSF analysis was performed for 31 patients, Selleckchem LY2157299 12 of whom presented HC. All 12 had an abnormal SVaq; those with communicating HC (n = 7) had an elevated SV and those with noncommunicating HC (n = 5) had a nil SV. None of the patients with a normal SVaq (n = 11) developed acute HC. Intraventricular bleeding led to more cases of acute HC (P =

.005), which was communicating in 58% of cases. In the chronic phase, CSF analysis was performed for 27 patients, 7 of whom presented HC. None of these 7 patients displayed a depressed SVaq. SAH led to changes in cerebrospinal fluid hydrodynamics in the majority of patients. Acute HC was communicating in most cases, even when there was intraventricular bleeding. In the late phase, all chronic HC were communicating and did not display aqueductal stenosis. “
“Cognitive impairment (CI) is an

important component of multiple sclerosis (MS) disability. A complex biological interplay between white matter (WM) and gray matter (GM) disease likely sustains CI. This Compound Library cell assay study aims to address this issue by exploring the association between the extent of normal WM and GM disease and CI. Cognitive function of 24 MS patients and mafosfamide 24 healthy volunteers (HVs) was studied using the Automated Neuropsychological Assessment Metrics (ANAM) battery. WM focal lesions and normal appearing WM (NAWM) volume in patients, cortical thickness (CTh) and deep GM structure volumes in both patients and HVs were measured by high field strength (3.0-Tesla; 3T) imaging. An analysis of covariance showed that patients performed worse than HVs on Code Substitution Delayed Memory (P= .04) and Procedural Reaction Time (P= .05) indicative of reduced performance in memory, cognitive flexibility, and processing speed. A summary score (Index of Cognitive Efficiency) indicating global test battery performance was also lower for the patient group (P= .04). Significant associations, as determined by the Spearman rank correlation tests, were noted between each of these 3 cognitive scores and measures of NAWM volume [CDD-TP1(r= .609; P= .0035), PRO-TP1 (r= .456; P= .029) and ICE (r= .489; P= .0129)], CTh (r= .5; P≤ .05) and volume of subcortical normal appearing GM (NAGM) structures (r= .4; P≤ .04), but not WM lesions. Both NAWM and NAGM volumes are related to CI in MS.