The ageing central nervous system in multiple sclerosis: the imaging perspective.

Area of Science:

• Neuroscience
• Immunology
• Radiology

Background:

• Ageing inherently causes brain changes like reduced plasticity and grey matter volume.
• Multiple sclerosis (MS) pathology interacts with age-related changes, potentially exacerbating clinical disability.
• Ageing may influence MS patient responses to therapies and their side effects.

Purpose of the Study:

• To review the immunopathological and MRI aspects of ageing in the central nervous system (CNS) in the context of MS.
• To explore how ageing influences MS pathology, clinical presentation, and diagnostic criteria.
• To discuss the role of MRI in understanding age-related neurodegeneration and treatment effects in MS.

Main Methods:

• Literature review focusing on immunosenescence, ageing-related CNS pathology, and clinical aspects of MS.
• Analysis of MRI findings related to ageing and MS, including neurodegeneration, iron dynamics, and myelin changes.
• Synthesis of current knowledge on the interplay between ageing and MS.

Main Results:

• Ageing-related brain changes can worsen MS pathology and clinical disability.
• Age influences MS diagnosis, comorbidity effects on imaging, and treatment efficacy.
• MRI is a key tool for visualizing and understanding the combined effects of ageing and MS.

Conclusions:

• The interaction between ageing and MS is complex, necessitating adjusted treatment considerations.
• Understanding age-related CNS changes is vital for managing MS patients effectively.
• MRI provides critical insights into the pathophysiology and treatment of MS in ageing individuals.