Magnetic resonance evidence of cerebellar cortical pathology in multiple sclerosis.
BACKGROUND
Although neuropathological observations suggest that cerebellar cortex is a major site of demyelination in multiple sclerosis (MS), only a few MRI studies on cerebellar cortical pathology in MS are available.


OBJECTIVE
To analyse cerebellar cortical volume (CCV) and leucocortical lesions (CL) in MS, and their impact on clinical disability.


METHODS
The authors studied 125 patients divided into 38 Clinical Isolated Syndrome (CIS), 35 relapsing remitting multiple sclerosis (RRMS), 27 secondary progressive multiple sclerosis (SPMS) and 25 primary progressive multiple sclerosis, and 32 normal controls (NC). CCV and cerebellar CL number and volume were evaluated by means of Freesurfer software and Double Inversion Recovery, respectively.


RESULTS
Compared with NC (mean 113.2 + or - 2.6 cm(3)), the CCV was significantly reduced in CIS (105.4 + or - 2.2 cm(3), p=0.018), RRMS (104.0 + or - 2.0 cm(3), p=0.012), SPMS (98.8 + or - 2.0 cm(3), p<0.001) and PPMS (100.6 + or - 2.2 cm(3), p<0.001), even after age, gender and mean cortical volume correction. CL were observed in all patient groups and were an independent predictor of CCV and cerebellar dysfunction.


CONCLUSIONS
The authors confirm that the cerebellar cortex is severely and early affected by MS pathology. The monitoring of cerebellar cortical atrophy and CL may help to understand the mechanism underlying disability progression in MS.
Calabrese
Massimiliano
M
Multiple Sclerosis Centre of Veneto Region, First Neurology Clinic, Department of Neurosciences, University Hospital of Padova, Via Giustiniani 3, 35128 Padua, Italy. calabresem@hotmail.it
Mattisi
Irene
I
Rinaldi
Francesca
F
Favaretto
Alice
A
Atzori
Matteo
M
Bernardi
Valentina
V
Barachino
Luigi
L
Romualdi
Chiara
C
Rinaldi
Luciano
L
Perini
Paola
P
Gallo
Paolo
P
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001284:Atrophy / Q000473:pathology; D002531:Cerebellum / Q000033:anatomy & histology / Q000473:pathology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D000068556:Interferon beta-1a; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000627:therapeutic use; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy / Q000473:pathology*; D011795:Surveys and Questionnaires; D055815:Young Adult
D000970:Antineoplastic Agents; D007155:Immunologic Factors; D000068576:Interferon beta-1b; D016899:Interferon-beta; D008942:Mitoxantrone; D000068556:Interferon beta-1a