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Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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Design and Implementation of an fMRI Study Examining Thought Suppression in Young Women with, and At-risk, for Depression
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Investigating Depression and MRI Associations in Middle Eastern Relapsing-Remitting Multiple Sclerosis.

Parisa Pishdad1, Banafsheh Zeinali-Rafsanjani1, Maryam Poursadeghfard2

  • 1Medical Imaging Research Center, Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Journal of Biomedical Physics & Engineering
|April 30, 2026
PubMed
Summary

Depression affects one-third of Middle Eastern Relapsing-Remitting Multiple Sclerosis (RRMS) patients, higher than controls. Brain imaging suggests plaque burden in specific areas may drive these symptoms.

Keywords:
Brain AtrophyDepressionMagnetic Resonance ImagingMiddle EastRelapsing-Remitting Multiple Sclerosis

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Area of Science:

  • Neurology
  • Neuroscience
  • Psychiatry

Background:

  • Depression is a common complication of Multiple Sclerosis (MS), impacting patient disability and quality of life.
  • Global depression prevalence in MS is approximately 27%, with limited data from the Middle East.
  • The neurobiological underpinnings of depression in Relapsing-Remitting Multiple Sclerosis (RRMS) remain incompletely understood.

Purpose of the Study:

  • To determine the prevalence of depression in Middle Eastern RRMS patients compared to a control group.
  • To assess the level of disability in RRMS patients using the Expanded Disability Status Scale (EDSS).
  • To investigate potential correlations between Magnetic Resonance Imaging (MRI) findings and depressive symptoms in RRMS.

Main Methods:

  • A cross-sectional study was conducted from June 2022 to June 2023, involving 105 RRMS patients and 111 controls from Shiraz, Iran.
  • Depression was assessed using the Beck Depression Inventory (BDI), and disability was measured by the EDSS.
  • MRI scans were analyzed for lesion burden and brain volume using VolBrain, with statistical analyses including t-tests, chi-squared tests, and correlation analyses.

Main Results:

  • Depression prevalence was higher in RRMS patients (33.3%) than controls (24.5%), particularly in younger females.
  • A weak correlation was observed between low mean EDSS scores and right insular cortex plaque volume.
  • Depressed RRMS patients exhibited greater plaque burdens in the left limbic and insular cortex, with reduced brain volume compared to non-depressed patients.

Conclusions:

  • Approximately one-third of Middle Eastern RRMS patients experience depression, a higher rate than observed in controls.
  • Increased plaque burden in the limbic and insular regions may indicate network dysconnectivity contributing to depressive symptoms.
  • The findings underscore the need for routine depression screening and tailored interventions for RRMS patients in the region.