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Conventional MRI-Based Structural Disconnection and Morphometric Similarity Networks and Their Clinical Correlates in

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Conventional MRI reveals that structural disconnection and morphometric similarity networks in multiple sclerosis (MS) are sensitive to brain damage and progression. These network changes correlate with clinical disability and predict long-term outcomes in people with MS (pwMS).

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Area of Science:

  • Neuroimaging
  • Network Neuroscience
  • Neurology

Background:

  • Multiple sclerosis (MS) is increasingly viewed as a network disorder.
  • Conventional MRI techniques are often insufficient for detailed brain network analysis in clinical settings.
  • Assessing structural and functional brain networks can provide insights into MS pathophysiology and clinical manifestations.

Purpose of the Study:

  • To evaluate cross-sectional and longitudinal structural disconnection and morphometric similarity networks in people with MS (pwMS) using conventional MRI.
  • To investigate the relationship between these network alterations and clinical disability (physical and cognitive).
  • To determine if network changes predict long-term disability progression independently of lesion load and atrophy.

Main Methods:

  • Retrospective analysis of 3T structural MRI from 461 pwMS and 55 healthy controls (HC).
  • Assessment of physical and cognitive disability using the Expanded Disability Status Scale (EDSS) and Symbol Digit Modalities Test (SDMT).
  • Calculation of structural disconnection and morphometric similarity networks using lesion masks and FreeSurfer reconstructions, analyzed with network-based statistics (NBS) and NBS-predict.

Main Results:

  • Structural disconnection was prominent around thalamic and cortical hubs; morphometric similarity was extensively disrupted in pwMS at baseline.
  • EDSS scores correlated with frontothalamic disconnection and disrupted morphometric similarity; SDMT scores associated with left-hemisphere cortico-subcortical disconnection.
  • Both network measures showed significant longitudinal progression, correlating with EDSS increases, and baseline disconnection predicted long-term confirmed disability progression (CDP).

Conclusions:

  • Conventional MRI-derived structural and morphometric similarity networks are sensitive to MS-related brain damage and disease progression.
  • These network metrics correlate with and predict clinical disability in pwMS, independent of global lesion burden and atrophy.
  • Network-based biomarkers derived from conventional MRI may enhance the assessment of MS severity and progression.