Multiple Sclerosis Brain: Beyond Hyperintense Images

Abstract

Introduction: Multiple Sclerosis (MS) is defined as a chronic, inflammatory demyelinating disease of the central nervous system. It has a multifactorial origin and it is characterized by disabling inflammatory attacks in the central nervous system. It affects any functional system (visual, motor, sensory, coordination, language and sphincter control) and it is considered as more disabling not traumatic disease of young population in the world.Objective: Describe brain anatomic changes in a group of MS patients through post-processing image techniques and correlate it with clinic abnormalities.Method: Thirty patients with relapsing-remitting form of MS and thirty healthy subjects were recruited, they were paired in age and sex. T1 and T2 weighted, FLAIR and DTI 3T MRI scans were acquired. Tractography, Voxel Based Morphometry (VBM) and cortical thickness processing analysis were done. Results:In relation of MS patients, tractography revealed that corticospinal tract and optic radiation number of fibres were lower than healthy subjects (p = 0.02), (p = 0.00). The number of fibres of evaluated tracts does not diminish significantly when disease duration increasing (p = 0.66), (p = 0.07), (p = 0.32). VBM revealed brain atrophy on subcortical areas of frontal and parietal lobes, occipital lobe, periventricular areas, brainstem, pulvinar thalamus and hippocampus; external capsule, extreme capsule, optic radiation, caudal fibres, arcuate fasciculus, fornix, frontal inferior gyrus, corona radiata, subcortical areas of parietotemporo-occipital lobes, corpus callosum head, white matter of pons and medulla oblongata and cingulate gyrus of MS patients. Cortical thickness analysis did not show significantly differences between MS and healthy subjects (p = 0.26). However, it diminished when disease duration increased (p = 0.03). Conclusions:In our MS patient's series was demonstrated morphologic abnormalities of grey and white mater, principally of subcortical and brainstem structures. These abnormalities increase when some clinical aspects get worse.