Cognitive Decline, Brain Atrophy More Rapid for Men With MS

October 20, 2011 (Amsterdam, the Netherlands) — A new investigation finds that 6 years after diagnosis, brain volumes and, particularly, cognition were more severely affected in men with multiple sclerosis (MS) than in women with the disease.

White and grey matter atrophy was present in all patients, and deep grey matter structures were also affected, but again particularly in men, the researchers, with lead author Menno M. Schoonheim, a PhD candidate from the Neuroscience Campus Amsterdam, Department of Radiology, VU University Medical Center, Amsterdam, the Netherlands, report.

Thalamic atrophy was most related to cognitive dysfunction out of all the brain structures investigated, Mr. Schoonheim added, and this atrophy was present in both men and women. However, the cognitive effect of the atrophy was mostly seen in the men. Volume changes in the right thalamus best predicted cognition, the authors note, and results were “clearly different” between the sexes.

“This highlights again that gender is important, not only in predisposition but also in clinical progression and cognitive status,” Mr. Schoonheim concluded. “However, longitudinal studies are needed to investigate the progression throughout the disease, because this is still a cross-sectional study.”

Their results were presented during the Young Scientific Investigators session here at the 5th Joint Triennial Congress of the European and Americas Committees for Treatment and Research in Multiple Sclerosis (ECTRIMS/ACTRIMS).

Grey and white matter atrophy is common in MS, as is cognitive dysfunction, the authors point out. MS is known for its sex effects, with women being more susceptible to the disease, but with men generally facing a worse prognosis.

However, few studies have looked at specific sex effects on atrophy, the authors note. In this study, the researchers investigated the relationship between atrophy and cognition in MS, “focusing on modification of this relationship by gender.”

Structural 3T magnetic resonance imaging, including 3DT1 for brain volumes, and cognitive evaluations were performed in 50 healthy control patients (20 men) and 120 patients with relapsing-remitting MS (40 men), part of an early-inception cohort, 6 years postdiagnosis. Sex groups were comparable with regard to age, education level, disability, lesion volume, and disease duration.

Normalized grey matter, white matter, and whole-brain volumes, corrected for head size, were calculated using a method called SienaX, and all subcortical grey matter volumes were determined using FIRST, a method that analyzes brain regions including the thalamus, caudate nucleus, putamen, and others, and provides measures of both right and left structures.