Volumetric changes in hypothalamic subunits in patients with relapsing remitting multiple sclerosis.

Area of Science:

• Neuroimaging
• Neurology
• Neuroscience

Background:

• The hypothalamus plays a crucial role in various physiological functions.
• Limited research exists on hypothalamic structural changes in relapsing remitting multiple sclerosis (RRMS).
• Understanding hypothalamic involvement in RRMS is vital due to frequently reported clinical associations.

Purpose of the Study:

• To quantify the volume of hypothalamic subunits and the total hypothalamus in RRMS patients.
• To investigate the relationship between hypothalamic volumes and disease severity markers, including total demyelinating lesion volume (TLV) and expanded disability status scale (EDSS).

Main Methods:

• A cross-sectional study involving 65 RRMS patients and 68 healthy controls (HC).
• Volumetric T1-weighted MRI images were used for fully automatic analysis of hypothalamic subunits and total hypothalamus volume.
• Multivariate analysis of covariance (MANCOVA) and partial correlation analyses were employed to assess volume changes and their correlations with EDSS and TLV.

Main Results:

• Significant volume reduction was observed in the total hypothalamus, anterior-superior, superior tubular, and posterior hypothalamus subunits in RRMS patients compared to HC.
• EDSS scores showed a negative correlation with the volumes of the anterior-superior, superior tubular, posterior hypothalamus, and total hypothalamus.
• TLV demonstrated a negative correlation with the volumes of the anterior-superior, anterior-inferior, superior tubular, posterior hypothalamus, and total hypothalamus.

Conclusions:

• The study confirms a reduction in total and specific hypothalamic subunit volumes in RRMS patients.
• These volumetric reductions are significantly associated with increased disease severity (EDSS) and lesion burden (TLV).
• Findings highlight the hypothalamus as a potential structural correlate of disability in RRMS.