Accelerated grey matter degeneration in relapsing remitting multiple sclerosis

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• Grey matter (GM) atrophy is a key indicator of neurodegeneration in multiple sclerosis (MS).
• Longitudinal data comparing MS patients and healthy controls (HC) for GM atrophy are limited.
• Identifying specific brain regions affected by atrophy and their clinical significance requires validation.

Purpose of the Study:

• To longitudinally map grey matter atrophy in relapsing-remitting MS (RRMS) patients.
• To compare atrophy patterns between RRMS patients and healthy controls (HC).
• To investigate the relationship between regional atrophy and clinical disease progression.

Main Methods:

• A multi-cohort longitudinal observational study involving 386 RRMS patients and 2,163 HC.
• Analysis of T1-weighted MRI scans over up to 12 years.
• Correlation of volumetric changes with clinical outcomes (EDSS, PASAT, FSS).

Main Results:

• Significant and replicable GM atrophy patterns were identified in the frontal lobes (superior frontal cortex, pars orbitalis) and thalami of RRMS patients.
• Atrophy in specific frontal regions and the caudate was more pronounced in MS patients compared to significantly older HC.
• Associations between regional volume changes and clinical outcomes were limited, with whole-brain volume changes showing better correlation.

Conclusions:

• Accelerated GM atrophy in the superior frontal lobe and thalamus is characteristic of RRMS and linked to disability progression.
• Thalamic and superior frontal cortex atrophy show potential as MS biomarkers.
• Further research is warranted to validate these regions as reliable MS biomarkers.