Neuropsychological correlates of cerebellar volumes in multiple sclerosis: an MRI volumetric analysis study

Abstract

The hallmark of Multiple Sclerosis (MS) pathophysiology is the damage to the myelin sheath around axons. The cerebellum is a predilection site for demyelination with a well-recognized role in motor and a rather understudied contribution to cognitive functions. The aim of this study is to investigate patterns of cerebellar grey and white matter pathology, expressed as reduced volume, as well as cortical thickness and their potential contribution to cognitive performance and disability status of patients with MS. 24 patients with MS underwent extensive neuropsychological assessment using paper and pencil tests and the Brain Health Assessment (BHA) tablet-based battery. Cerebellar lobular volumes and thickness were calculated using a volumetric analysis with automated segmentation of the cerebellum and its lobules. The main findings are a reduction of cerebellar grey matter (CGMV) and white matter volumes (CWMV) in lobule X and a widespread cerebellar cortical thinning in patients. Overall disease severity and neurological disability, assessed with the Expanded Disability Status Severity Scale, was correlated with fatigue and information processing speed tasks, but not with CGMV and CWMV. CWMV and CGMV of lobule I-II was negatively correlated with information processing speed, as well as visuospatial memory tests and, finally, inverse cortical thinning associations were noted between the whole cerebellum, lobule I-II, lobule III, lobule VI, Crus I, lobule VI-IIA and information processing speed and verbal luency tasks. The inverse associations observed may represent a compensatory mechanism activated in MS engaging additional high-level cortical areas functionally interconnected with the damaged cerebellum, in order to cope with the cognitive demands of a task.

Can volumetric analysis of the brain help diagnose isolated optic neuritis?

“…Inflammation in optic neuritis causes neurodegeneration in visual pathways as well as anterograde (retina to cortex) and retrograde (cortex to the retina) transsynaptic functional changes (Davion et al, 2020). Atrophy of brain regions has been demonstrated in many neurodegenerative processes, including disease or senility (Author & Javadi, 2019; Coupé et al, 2017; Iliadou et al, 2022). Our study's strength was that patients with neurological, autoimmune disease, and trauma history and MRI findings of senile cerebral atrophy or demyelinated plaques were omitted.…”

The Potential of Applied Brain Imaging in Research and Clinical Settings

“…The authors report considerable cerebellar reorganization decades after the poliomyelitis infection, which may be interpreted as compensation for anterior horn insult in infancy. Moreover, to unveil the contribution of cerebellum to the cognitive deficits of patients with multiple sclerosis (MS), Iliadou et al [14] investigated the patterns of cerebellar GM and WM alterations and their association with cognitive performance and disability status. An interesting finding of their study was the inverse correlation observed between cerebellar volumes and cortical thickness, and scores in the cognitive tests.…”