The Impact of Gray Matter Structural Changes on Clinical Disability in Multiple Sclerosis: Voxel-and Surface-Based Analyses.

Abstract

This study used voxel- and surface-based morphometry to analyze the changes in gray matter structure in MS patients and their correlation with clinical scales. An analysis was conducted on the structural magnetic resonance imaging data of 30 patients with MS who met the inclusion criteria and 30 healthy controls (HCs). Clinical disability was evaluated using the Expanded Disability Status Scale (EDSS) and the timed 25-foot walk test (T25FW). Cognitive function was assessed with the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Psychiatric symptoms were measured via the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD). Imaging data were also collected from the MS and healthy control groups, and SPM12 and CAT12 analyzed the images. After controlling for age and gender, voxel- and surface-based morphometry were used to study inter-group differences. Finally, the discrepancy data were correlated with the clinical scales. Compared to the HC group, the gray matter volume reduction in the MS group was mainly concentrated in the deep gray matter, with a small portion located in the cortical gray matter (FWE-corrected p-value < 0.05). Cortical thickness was significantly reduced in multiple dispersed regions of the brain bilaterally in the MS group compared to hc (FWE-corrected p-value < 0.05), and there was no obvious anatomical connection between these regions. Correlation analyses revealed: A negative correlation between caudate nucleus volume and EDSS scores (R = -0.415, p = 0.031); a positive correlation between the right parahippocampal gyrus and HAMA scores (R = 0.392, p = 0.039); a positive correlations of the right postcentral gyrus with both MMSE (R = 0.433, p = 0.021) and MoCA scores (R = 0.431, p = 0.022); a positive correlation between the left paracentral lobule and MoCA scores (R = 0.389, p = 0.041). A pattern of multiple gray matter structural changes was identified in our study, and a clinical correlation between structural changes was found. Grey matter volume and cortical thickness hold substantial promise as markers of disease progression and have the potential to respond to neuroprotective treatments for MS neurodegeneration.