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Gray matter atrophy in multiple sclerosis: a longitudinal study.

Elizabeth Fisher1, Jar-Chi Lee, Kunio Nakamura

  • 1Department of Biomedical Engineering, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. fishere@ccf.org

Annals of Neurology
|July 29, 2008
PubMed
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Gray matter atrophy accelerates in multiple sclerosis (MS) with disease progression, correlating with disability. White matter atrophy remains constant, suggesting different pathological mechanisms in relapsing-remitting MS versus secondary progressive MS.

Area of Science:

  • Neuroimaging
  • Neurology
  • Pathology

Background:

  • Multiple sclerosis (MS) is a chronic demyelinating disease affecting the central nervous system.
  • Gray matter (GM) atrophy is increasingly recognized as a significant contributor to neurological disability in MS.
  • Understanding the progression and predictors of GM atrophy is crucial for managing MS.

Purpose of the Study:

  • To quantify gray matter (GM) atrophy rates across all stages of multiple sclerosis (MS).
  • To identify predictors of GM atrophy using magnetic resonance imaging (MRI).
  • To explore the clinical correlations between GM atrophy and neurological disability.

Main Methods:

  • Longitudinal study over 4 years involving MS patients and healthy controls.
  • Standardized MRI and neurological examinations were performed.

Related Experiment Videos

  • Whole-brain, GM, and white matter atrophy rates were calculated; regression analysis identified predictors.

    • Main Results:

    • GM atrophy rate increased significantly with MS disease stage, from 3.4-fold in early MS to 14-fold in secondary progressive MS (SPMS) compared to controls.
    • White matter atrophy rates were consistently around 3-fold normal across all MS stages.
    • GM atrophy correlated with disability, and MRI measures explained 62% of GM atrophy variance in relapsing-remitting MS (RRMS), but not in SPMS.

    Conclusions:

    • Gray matter atrophy is a dominant pathological process in progressive MS, directly linked to neurological disability.
    • Distinct imaging correlates suggest differing pathological mechanisms in RRMS and SPMS.
    • These findings highlight the clinical importance of GM atrophy in MS and the need for further research into its underlying causes.