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CC BY 4.0 · Arq Neuropsiquiatr 2023; 81(02): 164-172
DOI: 10.1055/s-0043-1761492
Original Article

Correlation of brain segmental volume changes with clinical parameters: a longitudinal study in multiple sclerosis patients

Correlação das alterações do volume segmentar cerebral com parâmetros clínicos: um estudo longitudinal em pacientes com esclerose múltipla
Neslihan Eskut 
1   University of Health Sciences, Izmir Bozyaka Education and Research Hospital, Department of Neurology, Izmir, Turkey.
,
Ali Murat Koc 
2   Izmir Katip Celebi University, Ataturk Education and Research Hospital, Department of Radiology, Izmir, Turkey.
,
Asli Koskderelioglu 
1   University of Health Sciences, Izmir Bozyaka Education and Research Hospital, Department of Neurology, Izmir, Turkey.
,
Ismail Dilek 
3   University of Health Sciences, Izmir Bozyaka Education and Research Hospital, Department of Radiology, Izmir, Turkey.
,
Mustafa Agah Tekindal 
4   Izmir Katip Celebi University, Department of Biostatistics, Izmir, Turkey.
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Abstract

Objective To measure the cranial volume differences from 15 different parts in the follow-up of relapsing-remitting multiple sclerosis (RRMS) patients and correlate them with clinical parameters.

Methods Forty-seven patients with RRMS were included in the study. Patients were grouped into two categories; low Expanded Disability Status Scale (EDSS) (< 3; group 1), and moderate-high EDSS (≥ 3; group 2). Patients were evaluated with Beck Depression Inventory (BDI), Montreal Cognitive Assessment (MOCA), Symbol Digit Modalities Test (SDMT), Fatigue Severity Scale (FSS), and calculated Annualized Relapse Rate (ARR) scores. Magnetic resonance imaging (MRI) was performed with a 1.5T MRI device (Magnetom AERA, Siemens, Erlangen, Germany) twice in a 1-year period. Volumetric analysis was performed by a free, automated, online MRI brain volumetry software. The differences in volumetric values between the two MRI scans were calculated and correlated with the demographic and clinical parameters of the patients.

Results The number of attacks, disease duration, BDI, and FSS scores were higher in group 2; SDMT was higher in group 1. As expected, volumetric analyses have shown volume loss in total cerebral white matter in follow-up patients (p < 0.001). In addition, putaminal volume loss was related to a higher number of attacks. Besides, a negative relation between FSS with total amygdala volumes, a link between atrophy of globus pallidus and ARR, and BDI scores was found with the aid of network analysis.

Conclusions Apart from a visual demonstration of volume loss, cranial MRI with volumetric analysis has a great potential for revealing covert links between segmental volume changes and clinical parameters.

Resumo

Objetivo Medir as diferenças de dominância craniana de 15 regiões diferentes no seguimento de pacientes com esclerose múltipla recorrente-remitente (EMRR) e correlacioná-las com parâmetros clínicos.

Métodos Quarenta e sete pacientes com EMRR foram incluídos no estudo. Os pacientes foram agrupados em duas categorias; EDSS baixo (< 3; grupo 1) e EDSS médio-alto (≥ 3; grupo 2). Os pacientes foram avaliados com o Inventário de Depressão de Beck (BDI, na sigla em inglês), Montreal Cognitive Assessment (MOCA, na sigla em inglês), Symbol Digit Modality Tests (SDMT, na sigla em inglês), Fatigue Severity Scale (FSS, na sigla em inglês) e taxa de ataque anual (ARR, na sigla em inglês). Duas ressonâncias magnéticas (RMs) foram feitas em um ano com um aparelho de imagem de 1,5 T MR (Magnetom AERA, Siemens, Erlangen, Alemanha). A análise de volume foi realizada com um software de medição mestre cerebral de RM gratuito e automatizado. As diferenças volumétricas entre os dois exames de RM foram calculadas e correlacionadas com os parâmetros demográficos e clínicos dos pacientes.

Resultados Número de crises, duração da doença, escores BDI e FSS foram mais elevados no grupo 2; as pontuações do SDMT foram maiores no grupo 1. Como esperado, as análises volumétricas mostraram perda total de volume de substância branca no seguimento (p < 0,001). Além disso, a perda da dominância putaminal foi associada ao maior número de ataques. Além disso, uma relação negativa entre FSS e volume total da amígdala, e uma correlação entre ARR e BDI e atrofia do globo pálido foi determinada com a ajuda da análise de rede.

Conclusões Além da demonstração visual da perda de volume, a RM com análise volumétrica tem grande potencial para revelar alterações segmentares dominantes e conexões ocultas entre parâmetros clínicos.

Keywords

Multiple Sclerosis - Magnetic Resonance Imaging - Social Network Analysis - Atrophy

Palavras-chave

Esclerose Múltipla - Imageamento por Ressonância Magnética - Análise de Rede Social - Atrofia

Authors' Contributions

NE: conceptualization, methodology, formal analysis, writing – original draft, writing – review & editing, visualization; AMK: conceptualization, methodology, formal analysis, writing – original draft, writing – review & editing; AK: conceptualization, methodology, formal analysis, supervision; ID: conceptualization, methodology, formal analysis, visualization; MAT: conceptualization, methodology, formal analysis, statistical analysis.




Publication History

Received: 18 August 2022

Accepted: 05 September 2022

Article published online:
22 March 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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