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What explains gray matter atrophy in long-standing multiple sclerosis?
Martijn D Steenwijk1, Marita Daams, Petra J W Pouwels
1From the Departments of Radiology and Nuclear Medicine (M.D.S., M.D., F.B., H.V.), Anatomy and Neurosciences (M.D., J.J.G.G.), Physics and Medical Technology (P.J.W.P., H.V.), and Neurology (L.J.B., P.K.T., J.K., B.M.J.U.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.
Radiology
|April 26, 2014
Summary
White matter (WM) atrophy and lesions strongly predict gray matter (GM) atrophy in multiple sclerosis (MS). Cortical atrophy is linked to normal-appearing WM integrity loss, with weaker associations in progressive MS.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Multiple sclerosis (MS) is a chronic demyelinating disease affecting white matter (WM) and gray matter (GM).
- Understanding the relationship between WM abnormalities and GM atrophy is crucial for predicting disease progression and developing targeted therapies.
- Long-standing MS presents complex patterns of neurodegeneration involving both WM and GM structures.
Purpose of the Study:
- To investigate the association between focal and diffuse WM abnormalities and whole-brain, deep, and cortical GM atrophy in patients with long-standing MS.
- To identify specific WM measures that correlate with different types of GM atrophy.
- To explore potential differences in these relationships based on MS disease course.
Main Methods:
- Magnetic resonance (MR) imaging at 3 Tesla was used in 208 patients with MS (disease duration ≥ 10 years) and 60 healthy controls.
- Quantification of normalized GM volume (NGMV), normalized WM volume (NWMV), normalized deep GM volume (NDGMV), cortical thickness, and normalized lesion volume (NLV).
- Diffusion-tensor MR imaging assessed tissue integrity of normal-appearing WM (NAWM) and lesions; multiple linear regression analyzed associations.
Main Results:
- Patients with MS showed reduced NGMV, NDGMV, and cortical thickness compared to controls (P < .001).
- NWMV and NLV were significant predictors of NGMV and NDGMV, while NAWM fractional anisotropy, NLV, and patient demographics predicted cortical thickness.
- The association between GM atrophy and WM abnormalities was less pronounced in primary and secondary progressive MS compared to relapsing-remitting MS.
Conclusions:
- WM atrophy and lesion load are key drivers of whole-brain and deep GM atrophy in long-standing MS.
- Cortical atrophy is more closely related to the integrity loss in normal-appearing WM.
- The diminished relationship in progressive MS may suggest an independent neurodegenerative process contributing to GM atrophy.
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