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Mapping brain volume change across time in primary-progressive multiple sclerosis

  • Advanced Neuroimaging
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Abstract

Purpose

Detection and prediction of the rate of brain volume loss with age is a significant unmet need in patients with primary progressive multiple sclerosis (PPMS). In this study we construct detailed brain volume maps for PPMS patients. These maps compare age-related changes in both cortical and sub-cortical regions with those in healthy individuals.

Methods

We conducted retrospective analyses of brain volume using T1-weighted Magnetic Resonance Imaging (MRI) scans of a large cohort of PPMS patients and healthy subjects. The volume of brain parenchyma (BP), cortex, white matter (WM), deep gray matter, thalamus, and cerebellum were measured using the robust SynthSeg segmentation tool. Age- and gender-related regression curves were constructed based on data from healthy subjects, with the 95% prediction interval adopted as the normality threshold for each brain region.

Results

We analyzed 495 MRI scans from 169 PPMS patients, aged 20–79 years, alongside 563 exams from healthy subjects aged 20–86. Compared to healthy subjects, a higher proportion of PPMS patients showed lower than expected brain volumes in all regions except the cerebellum. The most affected areas were BP, WM, and thalamus. Lower brain volumes correlated with longer disease duration for BP and WM, and higher disability for BP, WM, cortex, and thalamus.

Conclusions

Constructing age- and gender-related brain volume maps enabled identifying PPMS patients at a higher risk of brain volume loss. Monitoring these high-risk patients may lead to better treatment decisions and improve patient outcomes.

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Data availability

The IXI dataset used for MRI scans of healthy subjects is publicly available at https://brain-development.org/ixi-dataset/. The MRI data and clinical information for PPMS patients used in this study are not publicly available due to privacy and ethical restrictions, as they were obtained from the SMCMS Data Registry, which contains sensitive patient information and is subject to strict confidentiality agreements.

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Acknowledgements

The authors extend their appreciation to the patients and caregivers whose essential contributions have been invaluable to this manuscript.

Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Multiple Sclerosis Center, Sheba Medical Center, Ramat-Gan, Israel

    Yehuda Warszawer, Michael Gurevich, Sapir Dreyer Alster, Yael Nissan, Emanuel Shirbint & Anat Achiron

  2. Arrow Program for Medical Research Education, Sheba Medical Center, Ramat-Gan, Israel

    Yehuda Warszawer

  3. Adelson School of Medicine, Ariel University, Ariel, Israel

    Yehuda Warszawer

  4. Department of Radiology, Sheba Medical Center, Ramat-Gan, Israel

    Ariel Kerpel & Chen Hoffmann

  5. Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Michael Gurevich, Ariel Kerpel, Chen Hoffmann & Anat Achiron

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  1. Yehuda Warszawer
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Correspondence to Yehuda Warszawer.

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The study was approved by the Internal Review Board of Sheba Medical Center. Informed consent was waived as the study was non-interventional and retrospective. Data was collected, coded, and analyzed according to the ethical standards of human experimentation.

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Warszawer, Y., Gurevich, M., Kerpel, A. et al. Mapping brain volume change across time in primary-progressive multiple sclerosis. Neuroradiology (2024). https://doi.org/10.1007/s00234-024-03354-7

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