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Updated: Mar 22, 2026
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
The role of global and regional gray matter volume decrease in multiple sclerosis
Matthias Grothe1, Martin Lotze2, Sönke Langner3
1Department of Neurology, University Medicine of Greifswald, Greifswald, Germany. matthias.grothe@uni-greifswald.de.
Abstract:
Disability in multiple sclerosis (MS) patients is associated with white matter (WM) and gray matter (GM) pathology, and both processes contribute differently over the disease course. Total and regional GM volume loss can be imaged via voxel-based morphometry (VBM). Here, we retrospectively analyzed a group of 213 MS patients [163 relapsing remitting (RR) and 50 secondary progressive (SP)] using semi-automated white matter (WM) lesion mapping and voxel-based morphometry (VBM). Our aim was to assess the association of increasing disability with decreasing total and regional GM volume. As expected, total GM volume and WM lesion load were associated with patients disability, measured with the Expanded Disability Status Scale (EDSS). The more impaired the patients, the greater the statistical association to the total GM volume. Regional volume loss in the cerebellar gray matter was associated with increasing EDSS and WM lesion volume. Furthermore, SPMS patients had significantly more gray matter volume loss in the cerebellum and the hippocampus compared to RRMS patients. Our results confirm histopathological studies emphasizing the important role of the cerebellum and the hippocampus in MS patients' disability.
Insights
Multiple sclerosis (MS) patients
Area of Science:
- Neuroscience
- Neurology
- Radiology
Background:
- Disability in multiple sclerosis (MS) is linked to white matter (WM) and gray matter (GM) damage.
- Gray matter volume loss can be quantified using voxel-based morphometry (VBM).
Purpose of the Study:
- To investigate the relationship between increasing disability and decreasing total and regional gray matter volume in MS patients.
- To compare gray matter changes between relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS) patients.
Main Methods:
- Retrospective analysis of 213 MS patients (163 RRMS, 50 SPMS).
- Utilized semi-automated WM lesion mapping and VBM to assess GM volume.
- Disability was measured using the Expanded Disability Status Scale (EDSS).
Main Results:
- Total GM volume and WM lesion load correlated with patient disability (EDSS).
- Regional GM volume loss in the cerebellum was associated with higher EDSS scores and WM lesion volume.
- SPMS patients exhibited greater GM volume loss in the cerebellum and hippocampus compared to RRMS patients.
Conclusions:
- Cerebellar and hippocampal gray matter atrophy significantly contribute to disability in MS.
- These findings underscore the critical roles of the cerebellum and hippocampus in MS pathogenesis and progression.
