Keywords Parole chiave: Cortical Atrophy, Expanded Disability Status Scale, Lesion Load, Multiple Sclerosis, Relapsing-Remitting, Voxel-Based Morphometry, Adult, Article, Brain Atrophy, Caudate Nucleus, Cingulate Gyrus, Controlled Study, Corpus Callosum, Disease Duration, Disease Severity, Female, Gray Matter, Human, Insula, Major Clinical Study, Motoneuron, Motor Cortex, Nuclear Magnetic Resonance Imaging, Parietal Lobe, Physical Disability, Pyramidal Tract, Sensorimotor Cortex, Tegmentum, Temporal Cortex, White Matter, Adolescent, Brain Mapping, Cluster Analysis, Data Interpretation, Statistical, Disability Evaluation, Functional Laterality, Image Processing, Computer-Assisted, Middle Aged, Young Adult, Brain Pathology, Functional Laterality Physiology, Relapsing-Remitting Pathology
Affiliations Affiliazioni: *** IBB - CNR ***
Biostructure and Bioimaging Institute, National Research Council, Edificio 10, Via Pansini, 5, 80131 Naples, Italy SDN Foundation, Naples, Italy Department of Neurological Sciences, University 'Federico ', Naples, Italy Neurology, Hermitage Hospital, Capodimonte, Naples, Italy Department of Biomorphological and Functional Sciences, University 'Federico ', Naples, Italy Neuroradiology, University 'Federico ', Naples, Italy
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A voxel-based morphometry study of disease severity correlates in relapsing- remitting multiple sclerosis
Previous studies have shown a preferential loss of grey matter in fronto-temporal regions in patients with multiple sclerosis. Studies of correlates of disease severity are more controversial, because some studies have suggested an association between sensorimotor cortex atrophy and Expanded Disability Status Scale score, while others did not find such a correlation. The objective of this study was to assess the correlation of regional loss of grey matter and white matter with indexes of clinical and radiological severity in relapsing–remitting multiple sclerosis, including the Expanded Disability Status Scale and lesion load. Correlations between Expanded Disability Status Scale, lesion load and disease duration were assessed in 128 patients with relapsing–remitting multiple sclerosis (Expanded Disability Status Scale range 1.0–6.0) using optimized voxel-based morphometry. Bilateral loss of grey matter in sensorimotor cortices was correlated with Expanded Disability Status Scale, and tissue loss also involved adjacent white matter, extending along pyramidal tracts to the brainstem. Increasing lesion load was correlated with loss of deep grey matter and white matter. No specific region of grey matter or white matter showed a significant correlation with disease duration. These findings support the hypothesis that motor neuron involvement plays a major role in the progression of physical disability. Lesion load accrual affects mainly highly interconnected subcortical structures, while disease duration has a less significant impact on brain atrophy, probably owing to the inter-subject heterogeneity of the clinical course of the disease.
A voxel-based morphometry study of disease severity correlates in relapsing- remitting multiple sclerosis
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