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Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
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Quantitative spinal cord MRI and sexual dysfunction in multiple sclerosis.

Estelle Seyman1,2, David Kim3, Aditya Bharatha4

  • 1Division of Neurology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.

Multiple Sclerosis Journal - Experimental, Translational and Clinical
|October 24, 2022
PubMed
Summary
This summary is machine-generated.

Sexual dysfunction in multiple sclerosis (MS) is not linked to spinal cord damage shown on MRI. However, anxiety, depression, and fatigue significantly correlate with sexual dysfunction in MS patients.

Keywords:
multiple sclerosisquality of lifequantitative MRIsexual dysfunctionspinal cord

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Area of Science:

  • Neurology
  • Radiology
  • Psychiatry

Background:

  • Sexual dysfunction (SD) is a common and often debilitating symptom experienced by individuals with multiple sclerosis (MS).
  • MS-related neurological damage, particularly in the spinal cord (SC), is suspected as a primary cause of SD in this population.

Purpose of the Study:

  • To investigate the relationship between quantitative magnetic resonance imaging (MRI) measures of the brain and spinal cord and the severity of sexual dysfunction in people with MS (pwMS).
  • To determine if objective MRI findings correlate with subjective reports of sexual dysfunction, while accounting for psychological factors.

Main Methods:

  • A pilot study involving 17 pwMS with self-reported SD.
  • Participants completed validated questionnaires for SD, mood, and fatigue.
  • Comprehensive brain and spinal cord MRI scans were performed, analyzing measures such as atrophy, lesion load, diffusion tensor imaging (DTI) indices (FA, MD, λ⊥, λ∥), and magnetization-transfer ratio (MTR).
  • Statistical analyses controlled for mood and fatigue symptoms to isolate associations with MRI metrics.

Main Results:

  • No significant correlations were found between quantitative brain or spinal cord MRI measures and the severity of SD in pwMS.
  • Anxiety (p=0.03), depression (p=0.05), and fatigue (p=0.04) were the only variables independently associated with SD severity.
  • A high prevalence of concurrent psychiatric diagnoses (65%) was noted among the participants.

Conclusions:

  • Quantitative MRI measures of the central nervous system do not appear to be directly correlated with sexual dysfunction severity in MS.
  • Psychiatric symptoms (anxiety, depression) and fatigue play a significant role in the experience of SD in pwMS.
  • A comprehensive, multidisciplinary approach is essential for managing the multifactorial nature of sexual dysfunction in multiple sclerosis.