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A voxel-based morphometry study of grey matter loss in MS patients with different clinical phenotypes

Antonia Ceccarelli1, Maria A Rocca, Elisabetta Pagani

  • 1Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy.

Neuroimage
|May 27, 2008
PubMed

Insights

Grey matter loss in multiple sclerosis (MS) varies by clinical phenotype, with progressive forms showing more significant changes. Lesion volume strongly correlates with regional grey matter loss across all MS types.

Area of Science:

  • Neuroimaging
  • Neurology
  • Radiology

Background:

  • Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system.
  • Grey matter (GM) atrophy is a key feature of MS pathology, contributing to disability.
  • Understanding regional GM changes across different MS phenotypes is crucial for prognosis and treatment.

Purpose of the Study:

  • To investigate regional grey matter (GM) volume differences in patients with multiple sclerosis (MS) across various clinical phenotypes.
  • To correlate these GM changes with T2 lesion volumes (LV) using voxel-based morphometry (VBM).
  • To differentiate GM loss patterns between clinically isolated syndrome (CIS), relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), and primary progressive MS (PPMS).

Main Methods:

  • Conventional MRI scans were acquired from 71 MS patients (26 RRMS, 27 SPMS, 18 PPMS), 28 CIS patients, and 21 controls.
  • Voxel-based morphometry (VBM) was employed to assess regional grey matter (GM) changes.
  • Correlation analysis was performed between GM volumes and T2 lesion volumes (LV).

Main Results:

  • No GM loss was observed in CIS patients compared to controls.
  • RRMS patients showed GM loss in the right pre- and postcentral gyri compared to CIS.
  • SPMS patients exhibited significant GM loss in widespread brain regions, cerebellum, and deep GM structures compared to RRMS.
  • PPMS patients showed GM loss in specific cortical and subcortical areas compared to SPMS.
  • Regional GM loss strongly correlated with brain T2 LV in all MS groups, with regional correlations observed in SPMS and PPMS.

Conclusions:

  • Grey matter volume loss in MS follows distinct regional patterns based on clinical phenotype.
  • GM atrophy is likely secondary to white matter inflammatory-demyelinating lesions.
  • Progressive forms of MS (SPMS and PPMS) demonstrate more pronounced and widespread GM loss.
  • The extent and location of T2 lesions are significantly associated with regional GM atrophy.

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