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Multiple Sclerosis l: Introduction01:19

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Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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Relating neocortical pathology to disability progression in multiple sclerosis using MRI.

J T Chen1, S Narayanan, D L Collins

  • 1Montreal Neurological Institute and Hospital, McConnell Brain Imaging Centre, 3801 University, WB 321, Montreal, Quebec, Canada H3A 2B4.

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Multiple sclerosis (MS) patients with worsening disability showed faster loss of cortical grey matter (cGM) thickness. New MRI methods reveal progressive cortical pathology linked to MS disability progression.

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Area of Science:

  • Neuroimaging
  • Neurology
  • Radiology

Background:

  • Multiple sclerosis (MS) is characterized by significant cortical grey matter (cGM) pathology.
  • Previous studies indicate a link between cortical atrophy and disability in MS.
  • Developing automated methods for measuring cGM changes is crucial for understanding MS progression.

Purpose of the Study:

  • To develop an automated method for measuring apparent cGM thickness and grey matter-white matter (GM/WM) interface integrity.
  • To longitudinally assess these measures in stable versus progressing MS patients.
  • To investigate the relationship between MRI-detected cortical pathology and disability progression in MS.

Main Methods:

  • Utilized T(1)-weighted MRI scans from MS patients (stable and progressing groups).
  • Developed automated methods to measure global and regional apparent cGM thickness and GM/WM interface integrity.
  • Analyzed changes cross-sectionally at baseline and longitudinally over approximately one year.

Main Results:

  • Progressing MS patients exhibited a significantly higher rate of whole-brain apparent cGM thickness loss compared to stable patients (-3.13%/year vs. 0.06%/year, P=0.002).
  • Regional analysis identified parietal and precentral cortex as areas showing significant cGM thickness loss in progressing patients.
  • While regional GM/WM interface changes were not significant, the progressing group showed an overall significant decrease in GM/WM interface integrity (P=0.003).

Conclusions:

  • Automated regional measurement of apparent cGM thickness increases sensitivity to cortical pathological changes in MS.
  • GM/WM interface integrity offers a novel index for disease-associated cortical changes.
  • Progression of disability in MS is associated with advancing MRI-detectable cortical pathology.