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MRI measures show significant cerebellar gray matter volume loss in multiple sclerosis and are associated with cerebellar dysfunction

Nuclear Magnetic Resonance Research Unit, Institute of Neurology, University College London, Queen Square, London, UK; Department of Neuroinflammation, Institute of Neurology, University College London, Queen Square, London, UKv.anderson{at}ion.ucl.ac.uk

LK Fisniku

Nuclear Magnetic Resonance Research Unit, Institute of Neurology, University College London, Queen Square, London, UK; Department of Neuroinflammation, Institute of Neurology, University College London, Queen Square, London, UK

DR Altmann

Nuclear Magnetic Resonance Research Unit, Institute of Neurology, University College London, Queen Square, London, UK; Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, UK

AJ Thompson

Nuclear Magnetic Resonance Research Unit, Institute of Neurology, University College London, Queen Square, London, UK; Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, Queen Square, London, UK

DH Miller

Nuclear Magnetic Resonance Research Unit, Institute of Neurology, University College London, Queen Square, London, UK; Department of Neuroinflammation, Institute of Neurology, University College London, Queen Square, London, UK

Background

Regional atrophy measures may offer useful information about the causes of specific clinical deficits in multiple sclerosis (MS).

Objective

To determine the magnitude of cerebellar gray and white matter (GM and WM) atrophy in patients with clinically isolated syndromes (CIS) and MS, and their role in clinical manifestations of cerebellar damage.

Methods

T1-weighted volumetric magnetic resonance imaging (MRI) of 73 patients [29 CIS, 33 relapsing–remitting MS (RRMS), 11 secondary progressive MS (SPMS)] was compared with 25 controls. GM and WM regions were generated using SPM5 and cerebellar regions delineated. Linear regression was used to investigate differences in tissue-specific cerebellar volumes between groups and the association with clinical measures.

Results

Mean cerebellar GM volume (CGMV) was 100.1 cm³ in controls, 96.4 cm³ in CIS patients, 91.8 cm³ in RRMS patients, and 88.8 cm³ in SPMS patients. Mean cerebellar WM volumes (CWMV) were 21.3 cm³, 20.4 cm³, 19.9 cm³, and 18.8 cm³, respectively. CGMV was reduced by 4.8 cm³ (P = 0.054) in RRMS patients, and 8.5 cm³ (P = 0.012) in SPMS patients, relative to controls. Only patients with SPMS showed a borderline significant reduction in CWMV compared with controls (mean 2.1 cm³, P = 0.053). CGMV was significantly smaller in patients assessed as having cerebellar dysfunction compared with patients who had normal cerebellar function. Significant associations of CGMV and CWMV with performance on the nine-hole peg test were also observed.

Conclusion

Clinically relevant GM atrophy occurs in the cerebellum of MS patients and is more prominent than WM atrophy. As such, it may provide complementary data to other regional atrophy and intrinsic tissue measures.

Key Words: atrophy • cerebellum • gray matter • multiple sclerosis • region of interest

This version was published on July 1, 2009

Multiple Sclerosis, Vol. 15, No. 7, 811-817 (2009)
DOI: 10.1177/1352458508101934


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