Structural changes in the brain of patients with relapsing-remitting multiple sclerosis compared to controls: a MRI-base
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ORIGINAL ARTICLE
Structural changes in the brain of patients with relapsing-remitting multiple sclerosis compared to controls: a MRI-based stereological study Zahra Heidari 1,2 & Hamidreza Mahmoudzadeh-Sagheb 1,2 & Ali Moghtaderi 3 & Negar Ramazanpour 3 & Enam Alhagh Charkhat Gorgich 4 Received: 22 March 2020 / Accepted: 5 May 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Background Multiple sclerosis (MS) is an inflammatory autoimmune disorder of the central nervous system characterized by demyelination, inflammation, gliosis, and axonal loss. Nowadays, increasing scientific reports have focused on neurodegenerative processes and structural changes of the disease underlying pathogenesis. Aim The aim of this study is a structural analysis of brain magnetic resonance images (MRIs) in patients with relapsing-remitting multiple sclerosis (RRMS) comparing with normal individuals. Methods This case-control study was carried out on MRIs of 20 patients with RRMS and 20 healthy controls in Zahedan, Iran. MR images with 4-mm slice thickness and 0.5-mm intervals in three anatomical planes (coronal, sagittal, axial) were acquired. Then, stereological parameters, including volume and volume density of different parts of the brain, based on Cavalries’ point counting method were measured in both groups. Data analyses were performed using Mann-Whitney U and Pearson’s correlation tests. Results The results of the study showed that there were no significant differences in total brain, hemispheres, gray matter, and basal nuclei volume and volume density between the two groups (p ˃ 0.05). However, the left hemisphere, cerebellum, lateral ventricles, brainstem, corpus callosum, and white matter volume in RRMS patients were significantly lower than those in controls (p ˂ 0.05). Conclusion The findings showed that quantitative assessments based on stereological method on brain MRIs facilitate clarifying neuropathology of the disease. Also, it can be helpful as a simple index for following up the clinical situation and assessing therapeutic efficiency in MS patients. It may provide a precise treatment approach and justification of symptoms in patients with MS. Keywords Brain . Magnetic resonance imaging . Neuroanatomy . Quantitative analysis . Relapsing-remitting multiple sclerosis . Stereology
Introduction * Hamidreza Mahmoudzadeh-Sagheb [email protected] 1
Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
2
Department of Histology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
3
Department of Neurology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
4
Department of Anatomical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Multiple sclerosis (MS) is the most common chronic inflammatory disease of the central nervous system (CNS), characterized by both relapses and insidious progression with a notably heterogeneous course, symptomatology, and severity [1, 2]. Demye
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