Subcortical brain volume changes linked to concern of falling in multiple sclerosis: a structural MRI study
Shay Menascu1, Tali Drori1, Alon Kalron2,3
1Multiple Sclerosis Center, Sheba Medical Center, 2 Derech Sheba Street, Tel Hashomer, Israel.
Journal of Neurology
|August 2, 2025
Summary
Concern of falling in people with multiple sclerosis (MS) is linked to brain structure changes. Reduced volumes in the basal ganglia and corpus callosum are associated with higher fall concern in MS patients.
Area of Science:
- Neuroscience
- Radiology
- Multiple Sclerosis Research
Background:
- Concern of falling (CoF) affects 50-60% of people with MS (pwMS).
- CoF is linked to physical and cognitive deficits.
- Neuroanatomical correlates of CoF in pwMS remain poorly understood.
Purpose of the Study:
- Investigate associations between subcortical brain volumes and CoF.
- Utilize structural MRI in a large cohort of pwMS.
Main Methods:
- 407 pwMS categorized into low, moderate, and high CoF groups based on FES-I.
- Volumetric MRI analysis using FreeSurfer for subcortical structures.
- Analyses adjusted for age, sex, intracranial volume, scanner type, and magnetic field strength.
Main Results:
- Significant brain volume differences observed across CoF groups.
- PwMS with high CoF showed reduced pallidum, putamen, and corpus callosum volumes.
- Subcortical volume reductions, especially in basal ganglia, correlated with higher CoF scores, even controlling for disability.
Conclusions:
- CoF in pwMS is associated with structural brain changes in motor control and emotional regulation areas.
- Findings suggest CoF involves both psychological and neuroanatomical factors.
