detecting cognitive dysfunction in multiple sclerosis with a magnetic resonance imaging rating scale a pilot study objective in multiple sclerosis ms magnetic resonance imaging mri predictors of cognitive impairment are based on sophisticated computergenerated analyses that are difficult to apply in clinical settings this study investigated the clinical usefulness of a new visual rating scale the cholinergic pathways hyperintensities scale chips in detecting cognitive dysfunctionmethods forty clinically definite ms patients underwent a brain mri based on the chips cholinergic pathway hyperintensities were rated in 10 regions on four axial slices computerized hyperintense lesion volumes were also obtained for cognitive testing the neuropsychological screening battery for multiple sclerosis was used low and high lesion score groups were computed based on the mean of the total chips score optimal sensitivity and specificity of the total chips score in detecting cognitive impairment were determined using a receiver operator characteristic curveresults despite a similar demographic profile subjects with a high lesion score performed significantly worse than the low lesion score group on verbal p 007 and visuospatial p 02 memory and on a global index of cognitive functioning p 001 optimal sensitivity 82 and specificity 83 were reached with a threshold total chips score of 18 points total chips score and total hyperintense lesion load were correlated sigma 082 p 0001conclusion chips is helpful in clinically predicting cognitive impairment in ms