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Walking disability measures in multiple sclerosis patients: Correlations with MRI-derived global and microstructural

Dejan Jakimovski1, Bianca Weinstock-Guttman2, Jesper Hagemeier1

  • 1Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.

Journal of the Neurological Sciences
|August 31, 2018
PubMed
Abstract

Insights

Walking disability in multiple sclerosis (MS) is linked to brain volume loss, particularly in deep gray matter and cortex. These findings highlight the importance of brain structure in maintaining mobility for MS patients.

Area of Science:

  • Neurology
  • Radiology
  • Neuroscience

Background:

  • The connection between walking impairments and MRI-assessed brain changes in multiple sclerosis (MS) patients is not fully understood.
  • Investigating macro- and microstructural MRI measures in relation to walking disability is crucial for MS patient care.

Purpose of the Study:

  • To determine the correlation between walking limitations and MRI-derived measures of lesions, atrophy, and white matter integrity in MS patients.
  • To identify specific brain regions and structural changes associated with walking difficulties.

Main Methods:

  • Seventy-one MS patients underwent clinical assessments, including the expanded timed get-up and go (ETGUG) and timed 25-foot walk (T25FW) tests.
  • MRI analysis included normalized brain volume (NBV), gray matter volume (GMV), white matter volume (WMV), cortical volume (CV), deep gray matter volume (DGMV), and lesion volume (LV). Diffusion tensor imaging (DTI) was also performed.
  • Statistical analyses involved Spearman correlation, partial correlation, and stepwise regression.

Main Results:

  • Both T25FW and ETGUG showed significant associations with T2-lesion volume (T2-LV), global brain volume (NBV), tissue-specific volumes (GMV, CV), and regional volumes (DGM, thalamus).
  • After adjusting for age, sex, and disease duration, ETGUG remained correlated with T1-LV, GMV, CV, and DGMV.
  • White matter volume (WMV) and DTI measures did not show significant associations with walking tests. Deep gray matter (DGM) volume emerged as the strongest predictor for T25FW, and cortical volume (CV) for ETGUG.

Conclusions:

  • Walking ability, even in MS patients with low disability, is significantly influenced by the loss of gray matter volume in cortical and deep nuclei regions.
  • These findings underscore the critical role of specific brain structures in maintaining walking function in MS.
  • MRI-derived volumetric measures, particularly of gray matter, are valuable indicators of walking impairment in MS.
Keywords:
Brain atrophyDiffusion-tensor imagingETGUGLesion volumeMRIMultiple sclerosisT25FWWalking disability

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