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Hippocampal atrophy in relapsing-remitting and primary progressive MS: a comparative study
V M Anderson1, L K Fisniku, Z Khaleeli
1Department of Neuroinflammation, UCL Institute of Neurology, Queen Square, London, UK. v.anderson@ion.ucl.ac.uk
Background:
In multiple sclerosis (MS), demyelination and neuroaxonal damage are seen in the hippocampus, and MRI has revealed hippocampal atrophy.
Objectives:
To investigate and compare hippocampal volume loss in patients with relapsing-remitting MS (RRMS) and primary progressive MS (PPMS) using manual volumetry, and explore its association with memory dysfunction.
Methods:
Hippocampi were manually delineated on volumetric MRI of 34 patients with RRMS, 23 patients with PPMS and 18 controls. Patients underwent neuropsychological tests of verbal and visuospatial recall memory. Linear regression was used to compare hippocampal volumes between subject groups, and to assess the association with memory function.
Results:
Hippocampal volumes were smaller in MS patients compared with controls, and were similar in patients with RRMS and PPMS. The mean decrease in hippocampal volume in MS patients was 317 mm(3) (9.4%; 95% CI 86 to 549; p = 0.008) on the right and 284 mm(3) (8.9%; 95% CI 61 to 508; p = 0.013) on the left. A borderline association of hippocampal volume with memory performance was observed only in patients with PPMS.
Conclusion:
Hippocampal atrophy occurs in patients with RRMS and PPMS. Factors additional to hippocampal atrophy may impact on memory performance.
Insights
Multiple sclerosis (MS) causes hippocampal atrophy in both relapsing-remitting MS (RRMS) and primary progressive MS (PPMS) patients, impacting memory. This study quantified volume loss and its relation to cognitive function.
Area of Science:
- Neuroimaging
- Neurology
- Medical Research
Background:
- Multiple sclerosis (MS) is characterized by demyelination and neuroaxonal damage, particularly affecting the hippocampus.
- Magnetic Resonance Imaging (MRI) studies have indicated significant hippocampal atrophy in MS patients.
Purpose of the Study:
- To compare hippocampal volume loss between relapsing-remitting MS (RRMS) and primary progressive MS (PPMS) using manual volumetry.
- To investigate the association between hippocampal atrophy and memory dysfunction in MS subtypes.
Main Methods:
- Manual delineation of hippocampi from volumetric MRI scans in 34 RRMS patients, 23 PPMS patients, and 18 controls.
- Neuropsychological testing assessed verbal and visuospatial recall memory.
- Linear regression analyzed group differences in hippocampal volume and its correlation with memory function.
Main Results:
- MS patients exhibited smaller hippocampal volumes compared to controls, with no significant difference between RRMS and PPMS groups.
- Mean hippocampal volume reduction in MS patients was 9.4% on the right and 8.9% on the left.
- A marginal association between hippocampal volume and memory performance was noted exclusively in PPMS patients.
Conclusions:
- Hippocampal atrophy is a common feature in both RRMS and PPMS.
- Memory deficits in MS may be influenced by factors beyond hippocampal atrophy.
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