Search

Background: Multiple sclerosis (MS) is a central nervous system disorder marked by progressive neurological impairments. Magnetic resonance imaging (MRI) parameters are key paraclinical measures that play a crucial role in the diagnosis, prognosis, and monitoring of MS-related disability. This study aims to analyze and summarize the existing literature on the correlation between MRI parameters and disability in people with MS (pwMS). Methods: The PubMed/MEDLINE, Embase, Scopus, and Web of Science databases were searched from inception to July 19, 2024, and a meta-analysis was carried out using R software version 4.4.0 and the random effects model used to determine the pooled correlation coefficient, with its 95% confidence interval (CI), between MRI measurements and disability scales. Results: Among 5741 studies, 383 studies with 39707 pwMS were included. The meta-analysis demonstrated that Expanded Disability Status Scale (EDSS) had significant correlations with cervical cord volume (r = -0.51, 95% CI: -0.62 to -0.38, I2 = 0%, p-heterogeneity = 0.86, p-value<0.01), cortical lesion volume (r = 0.45, 95% CI: 0.36 to 0.53, I2 = 68%, p-heterogeneity<0.01, p-value<0.01), brain volume (r = -0.40, 95% CI: -0.47 to -0.33, I2 = 41%, p-heterogeneity = 0.05, p-value<0.05), and grey matter volume (GMV) (r = -0.36, 95% CI: -0.49 to -0.21, I2 = 0%, p-heterogeneity = 0.53, p-value<0.01), respectively. Conclusion: This study offers evidence suggesting that cortical lesion volume, brain volume, GMV, and MRI measurements of the spinal cord may constitute reliable indicators for assessing disability in pwMS. [ABSTRACT FROM AUTHOR]

Background: Dysfunctions of the hypothalamic‐pituitary‐adrenal (HPA) axis can trigger multiple sclerosis (MS) symptoms. Mood disorders comorbid with MS are implicated in the HPA axis activation in most people with MS (pwMS). This study purposed to examine salivary cortisol (SC) levels and their association with mood disorders in pwMS. Methods: Forty‐three men as pwMS and sixteen men as healthy controls (HC) were included in this study. pwMS and HC completed the Beck Depression Inventory (BDI), 36‐Item Short Form Survey (SF‐36), Fatigue Severity Scale (FSS), Depression Anxiety and Stress Scale, and Hospital Anxiety and Depression Scale questionnaires. SC levels were also measured in pwMS and HC. A linear regression model was used to analyze the relationship between the Expanded Disability Status Scale (EDSS) and mood disorders and SC levels. Pearson's or Spearman's tests examined the correlation between SC levels and mood disorders. Results: The SC level, anxiety, depression, fatigue, and stress were significantly higher in pwMS than in HC (p < 0.05). pwMS also showed significant correlations between SC levels and role physical (r = 0.3, p < 0.05) and emotional (r = 0.34, p < 0.05) in SF‐36. Among SF‐36 domains, only general health (β = −0.72, p < 0.05) and physical functioning (β = −1.61, p < 0.05) were negatively associated with disease duration. No correlation was found between SC levels and anxiety, depression, and fatigue (p > 0.05). Conclusions: The pwMS showed mild to moderate depression, anxiety, and fatigue. Only general health and physical functioning as aspects of quality of life were related to disease duration, while SC levels, mood disorders, and other quality‐of‐life domains were not associated with clinical characteristics. Also, this study failed to find a significant role for SC as a valuable marker in approaching mood disorders in pwMS. [ABSTRACT FROM AUTHOR]

• The overall prevalence of osteopenia and osteoporosis among people with multiple sclerosis (pwMS) was 41.4 % and 14.2 %, respectively. • The pooled prevalence of overall fracture was found to be 12.8 % in pwMS. • PwMS were at a higher risk of osteopenia (2-fold), osteoporosis (1.7-fold), and overall fractures (1.9-fold). People with multiple sclerosis (PwMS) exhibit reduced bone mineral density (BMD) across several anatomical regions. Studies have indicated that PwMS are at a heightened risk of fractures due to decreased BMD and increased prevalence of osteopenia and osteoporosis. This study aimed to investigate the prevalence and risk of osteopenia, osteoporosis, and fracture among PwMS. Relevant studies were identified through comprehensive searches of databases (PubMed/MEDLINE, Scopus, Embase, and Web of Science) from January 1, 2000, to January 21, 2024. R software version 4.4.0 and random-effects models were employed to estimate the pooled prevalence, odds ratio (OR), and risk ratio (RR) of osteopenia, osteoporosis, and fracture among PwMS, along with their respective 95 % confidence intervals (CIs). From a total of 2039 articles, 51 studies with 1,503,785 PwMS met our inclusion criteria. The pooled prevalence of osteopenia, osteoporosis, and overall fracture among PwMS was 41.41 % (95 % CI: 36.14% to 46.69 %, I2=97 %), 14.21 % (95 % CI: 10.75 % to 17.68 %, I2=99 %), and 12.84 % (95 % CI: 8.49 % to 17.19 %, I2 = 100 %), respectively. The likelihood of osteopenia (OR=2.02, 95 % CI: 1.46 to 2.8, p -value<0.01, I2=17 %) and osteoporosis (OR=1.71, 95 % CI: 1.27 to 2.31, p -value<0.01, I2=74 %), as well as the probability of overall fracture (RR=1.86, 95 % CI: 1.61 to 2.14, p -value<0.01, I2=74 %) were significantly higher in PwMS than healthy controls (HCs). PwMS were at a substantially increased risk of developing osteopenia (2-fold), osteoporosis (1.7-fold), and overall fractures (1.9-fold). Well-designed studies are needed to explore these associations further. [ABSTRACT FROM AUTHOR]

• The study reviewed 13,559 articles, ultimately 136 were included in this review. • Significant correlations were found between thalamic volume and various cognitive function tests, including the Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised-Total Recall (BVMT-TR), California Verbal Learning Test-Total Recall (CVLT-TR), and Delis–Kaplan Executive Function System (DKEFS). • In studies analyzing volumes and lesions, thalamic volume was found to have the strongest correlation with cognitive performance in multiple sclerosis. Several studies have shown the different relationships between cognitive functions and structural magnetic resonance imaging (MRI) measurements in people with multiple sclerosis (pwMS). However, there is an ongoing debate regarding the magnitude of correlation between MRI measurements and specific cognitive function tests. This systematic review and meta-analysis aimed to synthesize the most consistent correlations between MRI measurements and cognitive function in pwMS. PubMed/MEDLINE, Embase, Scopus, and Web of Science databases were systematically searched up to February 2023, to find relevant data. The search utilized syntax and medical subject headings (MeSH) relevant to cognitive performance tests and MRI measurements in pwMS. The R software version 4.3.3 with random effect models was used to estimate the pooled effect sizes. 13,559 studies were reviewed, of which 136 were included. The meta-analyses showed that thalamic volume had the most significant correlations with Symbol Digit Modalities Test (SDMT) r = 0.47 (95 % CI: 0.39 to 0.56, p < 0.001, I2 = 88 %), Brief Visual Memory Test-Revised-Total Recall (BVMT-TR) r = 0.51 (95 % CI: 0.36 to 0.66, p < 0.001, I2 = 81 %), California Verbal Learning Test-II-Total Recall (CVLT-TR) r = 0.47 (95 % CI: 0.34 to 0.59, p < 0.001, I2 = 69 %,), and Delis-Kaplan Executive Function System (DKEFS) r = 0.48 (95 % CI: 0.34 to 0.63, p < 0.001, I2 = 22 %,). We conclude that thalamic volume exhibits highest relationships with information processing speed (IPS), visuospatial learning-memory, verbal learning-memory, and executive function in pwMS. A comprehensive understanding of the intricacies of the mechanisms underpinning this association requires additional research. [ABSTRACT FROM AUTHOR]

Background/objective: Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are neuroinflammatory conditions with overlapping clinical and imaging features. Distinguishing between these diseases is crucial for appropriate diagnosis and management. Magnetic resonance imaging (MRI) may have the potential to differentiate these disorders. Nonetheless, studies exhibit inconsistencies regarding which MRI measurements most effectively distinguish between these disorders. Hence, this review aimed to evaluate the differences in MRI volumetry between people with MS (PwMS) and people with NMOSD (PwNMOSD)., Methods: A systematic search was conducted across PubMed/MEDLINE, Embase, Scopus, and Web of Science up to May 12, 2024, to identify studies assessing conventional and volumetric MRI in PwMS and PwNMOSD. The standard mean difference (SMD) of MRI measurements and its 95% confidence interval (CI) were estimated using R version 4.4.0 with a random-effects model., Results: Forty-eight original studies that assessed conventional MRI measurements in 2592 PwMS and 1979 PwNMOSD were included. The meta-analysis revealed that PwMS had significantly higher T2 lesion volume (SMD = 1.51, 95% CI: 0.53 to 2.48, p = 0.002) and T1 lesion count (SMD = 1.08, 95% CI: 0.56 to 1.6, p < 0.001) than PwNMOSD. PwMS also exhibited significantly reduced thalamic volume (SMD = -1.26, 95% CI: -1.8 to -0.73, p < 0.001) and grey matter volume (GMV) (SMD = -0.65, 95% CI: -0.92 to -0.37, p < 0.001). Other MRI volumetry, such as the brain and putamen volumes, showed more pronounced atrophy in PwMS., Conclusion: Significant differences in MRI volumetry between MS and NMOSD highlight the potential of MRI as a critical diagnostic tool. These findings emphasize the need for standardized MRI protocols and advanced imaging techniques to enhance diagnostic accuracy and clinical management of these conditions., Competing Interests: Declarations. Conflicts of interest: The authors declare no competing interest regarding the publication of this paper. Compliance with ethical standards: Not applicable. Informed consent: This manuscript has been approved for publication by all authors., (© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: One of the complications of multiple sclerosis (MS) is cognitive impairment (CI). The prevalence of CI is reported variously in previous studies. The goal of this systematic review and meta-analysis to estimate pooled prevalence of CI in patients with MS and also the prevalence of CI based on the type of applied test., Methods: Two independent researchers systematically searched PubMed, Scopus, EMBASE, Web of Science, and google scholar as well as gray literature (conference abstracts, references of the references) which were published before up January 2022., Results: We found 4089 articles by literature search, after deleting duplicates 3174 remained. Ninety articles remained for meta-analysis. The pooled prevalence of CI using all types of tests was 41% (95% CI: 38-44%) (I2=91.7%, p<0.001). The pooled prevalence of CI using BRB test was 39% (95%CI: 36-42%) (I2=89%, p<0.001). The pooled prevalence of CI using BICAMS was 44% (95%CI: 37-51%, I2=95.4%, p<0.001). The pooled prevalence of CI using MACFIMS was 44% (95% CI: 36-53%) (I2=89.3%, p<0.001)., Conclusions: The pooled prevalence of cognitive impairment in patients with MS is estimated as 41%, so CI it should be considered by clinicians., Competing Interests: The authors declared that they had no conflict of interest., (© The Author(s).)