Structural changes in the brain of patients with relapsing-remitting multiple sclerosis compared to controls: a MRI-based stereological study

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.