Gray matter atrophy in relapsing-remitting multiple sclerosis is associated with white matter lesions in connecting fibers

Matthias Bussas, Sophia Grahl, Viola Pongratz, Achim Berthele, Christiane Gasperi, Till Andlauer, Christian Gaser, Jan S. Kirschke, Benedikt Wiestler, Claus Zimmer, Bernhard Hemmer, Mark Mühlau

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: Lesions of brain white matter (WM) and atrophy of brain gray matter (GM) are well-established surrogate parameters in multiple sclerosis (MS), but it is unclear how closely these parameters relate to each other. Objective: To assess across the whole cerebrum whether GM atrophy can be explained by lesions in connecting WM tracts. Methods: GM images of 600 patients with relapsing-remitting MS (women = 68%; median age = 33.0 years, median expanded disability status scale score = 1.5) were converted to atrophy maps by data from a healthy control cohort. An atlas of WM tracts from the Human Connectome Project and individual lesion maps were merged to identify potentially disconnected GM regions, leading to individual disconnectome maps. Across the whole cerebrum, GM atrophy and potentially disconnected GM were tested for association both cross-sectionally and longitudinally. Results: We found highly significant correlations between disconnection and atrophy across most of the cerebrum. Longitudinal analysis demonstrated a close temporal relation of WM lesion formation and GM atrophy in connecting fibers. Conclusion: GM atrophy is associated with WM lesions in connecting fibers. Caution is warranted when interpreting group differences in GM atrophy exclusively as differences in early neurodegeneration independent of WM lesion formation.

Original languageEnglish
Pages (from-to)900-909
Number of pages10
JournalMultiple Sclerosis Journal
Volume28
Issue number6
DOIs
StatePublished - May 2022
Externally publishedYes

Keywords

  • Biomarkers
  • T2 lesions
  • atrophy
  • multiple sclerosis
  • outcome measurement
  • relapsing/remitting

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