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Correlation of brain segmental volume changes with clinical parameters: a longitudinal study in multiple sclerosis
Neslihan Eskut1, Ali Murat Koc2, Asli Koskderelioglu1
1University of Health Sciences, Izmir Bozyaka Education and Research Hospital, Department of Neurology, Izmir, Turkey.
Arquivos De Neuro-Psiquiatria
|March 22, 2023
Summary
Relapsing-remitting multiple sclerosis (RRMS) patients show brain volume loss, particularly in white matter. Cranial MRI volumetric analysis reveals links between specific brain region atrophy and clinical symptoms like fatigue and depression.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Multiple Sclerosis (MS) is a chronic demyelinating disease affecting the central nervous system.
- Relapsing-remitting MS (RRMS) is the most common form, characterized by distinct attacks and remissions.
- Monitoring disease progression and its impact on brain structure is crucial for effective management.
Purpose of the Study:
- To quantify cranial volume changes in 15 brain regions in RRMS patients over one year.
- To correlate these volumetric changes with clinical parameters including disability, depression, cognition, and fatigue.
- To explore the utility of volumetric MRI in identifying subtle structural changes and their clinical relevance.
Main Methods:
- Forty-seven RRMS patients were assessed using clinical scales (EDSS, BDI, MOCA, SDMT, FSS) and annualized relapse rate (ARR).
- Two MRI scans were performed 1 year apart using a 1.5T MRI scanner.
- Automated online software was used for volumetric analysis of brain structures, with differences calculated and correlated with clinical data.
Main Results:
- Significant whole cerebral white matter volume loss was observed in RRMS patients over the follow-up period (p < 0.001).
- Putaminal volume loss correlated with a higher number of relapses.
- Atrophy in the globus pallidus was linked to ARR, while amygdala volume showed a negative correlation with Fatigue Severity Scale (FSS) scores. Beck Depression Inventory (BDI) scores were also associated with specific regional atrophy.
Conclusions:
- Cranial MRI with volumetric analysis effectively demonstrates progressive brain volume loss in RRMS.
- This technique reveals significant correlations between regional brain atrophy and key clinical parameters, including relapse activity, fatigue, and depression.
- Volumetric MRI analysis holds substantial potential for detecting subclinical changes and understanding the complex relationship between brain structure and clinical manifestations in RRMS.
