How does the brain age in individuals with multiple sclerosis? A systematic review

Area of Science:

• Neurology
• Neuroimaging
• Gerontology

Background:

• Multiple Sclerosis (MS) is a neurological disorder characterized by demyelination, lesions, and atrophy in the central nervous system.
• Brain atrophy in MS correlates with physical and cognitive symptoms, making MRI a key outcome measure.
• Emerging research investigates the impact of aging on MS-related structural brain changes.

Purpose of the Study:

• To systematically review existing literature on how aging affects brain structure in individuals with Multiple Sclerosis.
• To determine if aging amplifies MS-related brain atrophy.
• To explore differences in atrophy patterns between younger and older MS cohorts and by sex.

Main Methods:

• A systematic literature review was conducted.
• Studies included used magnetic resonance imaging (MRI) to assess aging effects in adults with MS.
• Twenty-one studies met the eligibility criteria for analysis.

Main Results:

• Gray matter atrophy is more pronounced in older adults with MS, especially in subcortical regions like the thalamus.
• Rates of brain atrophy were similar across younger and older cohorts but varied by specific brain regions.
• Males may exhibit greater brain atrophy compared to females with MS.

Conclusions:

• Aging appears to exacerbate brain atrophy in Multiple Sclerosis, particularly affecting gray matter in older individuals.
• While atrophy rates may be comparable, regional differences exist between age groups.
• Further multimodal MRI studies are necessary to track longitudinal changes in both sexes, especially in middle to older adulthood.