Analysis of ageing-associated grey matter volume in patients with multiple sclerosis shows excess atrophy in subcortical regions

Abstract

Age of onset in multiple sclerosis (MS) exerts an influence on the course of disease. This study examined whether global and regional brain volumes differed between “younger” and “older” onset MS subjects who were matched for short disease duration, mean 1.9 years and burden as measured by the MS Severity Score and relapses.21 younger-onset MS subjects (age 30.4 ± 3.2 years) were compared with 17 older-onset (age 48.7 ± 3.3 years) as well as age-matched controls (n = 31, 31.9 ± 3.5 years and n = 21, 47.3 ± 4.0 years). All subjects underwent 3D volumetric T1 and T2-FLAIR imaging. White matter (WM) and grey matter (GM) lesions were outlined manually. Lesions were filled prior to tissue and structural segmentation to reduce classification errors.Volume loss versus control was predominantly in the subcortical GM, at > 13% loss. Younger and older-onset MS subjects had similar, strong excess loss in the putamen, thalamus, and nucleus accumbens. No excess loss was detected in the amygdala or pallidum. The hippocampus and caudate showed significant excess loss in the younger group (p < 0.001) and a strong trend in the older-onset group.These results provide a potential imaging correlate of published neuropsychological studies that reported the association of younger age at disease onset with impaired cognitive performance, including decreased working memory.

The hippocampus in multiple sclerosis

“…31,34,35 A study that examined the role of patients' age on brain GM volumetric abnormalities found significant excess atrophy of the hippocampus in younger-onset (mean age=30.4 years, SD=3.2 years) versus olderonset (mean age=48.7 years, SD=3.3 years), whereas for all other GM structures, atrophy was similar in the two groups, suggesting severe tissue abnormalities in hippocampal substructures in people with earlier onset disease. 36 In line with other neurological conditions 37,38 and with pathology studies in MS, 16,17 studies that have applied regional methods of analysis have suggested that hippocampal subregions have different vulnerability to damage, with CA1 and the subiculum as the most severely damaged regions. 35,39,40 Poor performance in hippocampal-related functions, such as visuospatial memory, verbal memory and memory acquisition correlated with atrophy of the previous regions.…”

Longitudinal Performance of Plasma Neurofilament Light and Tau in Professional Fighters: The Professional Fighters Brain Health Study

“…Thus, plasma measures of NF-L may be more sensitive than tau to detect damage associated with recent repetitive sub concussive impacts. In addition, the strong relationships between baseline NF-L levels and various subcortical regional volumes, may reflect accumulated chronic injury to white matter tracts and resultant inflammation or wallerian degeneration of the structures they innervate (26).…”

Longitudinal Assessment of Multiple Sclerosis with the Brain‐Age Paradigm

“…Neuroimaging, particularly magnetic resonance imaging (MRI), offers a window into the longitudinal evolution of atrophy patterns in MS and aging, allowing them to be compared and contrasted. [9][10][11][12] For example, Ghione and colleagues showed similar rates in the percentage of brain volume change between patients with MS and agematched healthy controls, although patients with MS started from a lower baseline volume. Conversely, this study found scant percentage lateral ventricle volume change in patients with MS, whereas healthy controls volumes increased to reach similar volumes as patients with MS by age 60 years.…”