Regional cerebellar atrophy related to disability and cognitive progression in multiple sclerosis

Objective: The implications of cerebellar pathology on clinical disease progression in multiple sclerosis (MS) remain unclear. This study investigated regional cerebellar atrophy related to physical disability and cognitive impairment progression. Methods: We included 331 MS patients and 95 controls...

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Main Authors: Myrte Strik, Iris Dekker, Aurélie Ruet, Hanneke E. Hulst, Mike P. Wattjes, Frederik Barkhof, Bernard M.J. Uitdehaag, Joep Killestein, Menno M. Schoonheim
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:NeuroImage: Clinical
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213158225000622
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author Myrte Strik
Iris Dekker
Aurélie Ruet
Hanneke E. Hulst
Mike P. Wattjes
Frederik Barkhof
Bernard M.J. Uitdehaag
Joep Killestein
Menno M. Schoonheim
author_facet Myrte Strik
Iris Dekker
Aurélie Ruet
Hanneke E. Hulst
Mike P. Wattjes
Frederik Barkhof
Bernard M.J. Uitdehaag
Joep Killestein
Menno M. Schoonheim
author_sort Myrte Strik
collection DOAJ
description Objective: The implications of cerebellar pathology on clinical disease progression in multiple sclerosis (MS) remain unclear. This study investigated regional cerebellar atrophy related to physical disability and cognitive impairment progression. Methods: We included 331 MS patients and 95 controls (Amsterdam MS Cohort, 229 patients and 58 controls re-evaluated after 5 years). Assessments included baseline MRI, and disability and cognition at baseline and follow up. Cerebellar (sub)cortex was parcellated, volumetric data were determined and related to baseline disability and cognition. Longitudinal progression was explored only for regions with significant baseline correlations. Results: At baseline, patients had mild disability (median EDSS 3.0) and 46% showing mild-to-severe cognitive impairment. At follow-up, 34.5% showed EDSS progression and 26.6% cognitive decline. All global and most regional volumes showed atrophy. Cross-sectionally, atrophy of several regions encompassing both anterior and posterior lobes correlated with both disability and cognition, while some correlated with EDSS only. Additionally, cerebellar nuclei only correlated with cognition. Cerebellar volumes were mainly related to information processing speed, working and verbal memory. Longitudinally, atrophy in the posterior lobe, lobule VI and VIIIb, and vermis VI, correlated with cognitive decline, while no variables correlated with disability progression. Conclusion: Regional cerebellar atrophy in both anterior and posterior lobes correlated with disability and cognitive impairment. Posterior regional atrophy was correlated with longitudinal cognitive decline, but none correlated with disability progression. Further research is required to elucidate these relationships.
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spelling doaj-art-b5a72941df474ca78960b9cff6fcc8c32025-08-20T02:34:43ZengElsevierNeuroImage: Clinical2213-15822025-01-014610379210.1016/j.nicl.2025.103792Regional cerebellar atrophy related to disability and cognitive progression in multiple sclerosisMyrte Strik0Iris Dekker1Aurélie Ruet2Hanneke E. Hulst3Mike P. Wattjes4Frederik Barkhof5Bernard M.J. Uitdehaag6Joep Killestein7Menno M. Schoonheim8Anatomy and Neurosciences, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, the Netherlands; Spinoza Centre for Neuroimaging, Amsterdam, the Netherlands; Computational Cognitive Neuroscience and Neuroimaging, Netherlands Institute for Neuroscience, Royal Netherlands Academy for Arts and Sciences (KNAW), Amsterdam, the Netherlands; Corresponding author at: Spinoza Centre for Neuroimaging, Meibergdreef 75, 1105 BK Amsterdam, the Netherlands.Departments of Radiology and Nuclear Medicine, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, the Netherlands; Departments of Neurology, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, the NetherlandsService de Neurologie, Pathologies inflammatoires du système nerveux central, CHU de Bordeaux, Bordeaux, France; U1215 INSERM, Neurocentre Magendie, Université de Bordeaux, Bordeaux, FranceInstitute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the NetherlandsDepartments of Radiology and Nuclear Medicine, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, the Netherlands; Department of Neuroradiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDepartments of Radiology and Nuclear Medicine, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing, University College London, UKDepartments of Neurology, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, the NetherlandsDepartments of Neurology, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, the NetherlandsAnatomy and Neurosciences, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, the NetherlandsObjective: The implications of cerebellar pathology on clinical disease progression in multiple sclerosis (MS) remain unclear. This study investigated regional cerebellar atrophy related to physical disability and cognitive impairment progression. Methods: We included 331 MS patients and 95 controls (Amsterdam MS Cohort, 229 patients and 58 controls re-evaluated after 5 years). Assessments included baseline MRI, and disability and cognition at baseline and follow up. Cerebellar (sub)cortex was parcellated, volumetric data were determined and related to baseline disability and cognition. Longitudinal progression was explored only for regions with significant baseline correlations. Results: At baseline, patients had mild disability (median EDSS 3.0) and 46% showing mild-to-severe cognitive impairment. At follow-up, 34.5% showed EDSS progression and 26.6% cognitive decline. All global and most regional volumes showed atrophy. Cross-sectionally, atrophy of several regions encompassing both anterior and posterior lobes correlated with both disability and cognition, while some correlated with EDSS only. Additionally, cerebellar nuclei only correlated with cognition. Cerebellar volumes were mainly related to information processing speed, working and verbal memory. Longitudinally, atrophy in the posterior lobe, lobule VI and VIIIb, and vermis VI, correlated with cognitive decline, while no variables correlated with disability progression. Conclusion: Regional cerebellar atrophy in both anterior and posterior lobes correlated with disability and cognitive impairment. Posterior regional atrophy was correlated with longitudinal cognitive decline, but none correlated with disability progression. Further research is required to elucidate these relationships.http://www.sciencedirect.com/science/article/pii/S2213158225000622CerebellumStructural MRIMultiple sclerosisDisabilityCognitionAtrophy
spellingShingle Myrte Strik
Iris Dekker
Aurélie Ruet
Hanneke E. Hulst
Mike P. Wattjes
Frederik Barkhof
Bernard M.J. Uitdehaag
Joep Killestein
Menno M. Schoonheim
Regional cerebellar atrophy related to disability and cognitive progression in multiple sclerosis
NeuroImage: Clinical
Cerebellum
Structural MRI
Multiple sclerosis
Disability
Cognition
Atrophy
title Regional cerebellar atrophy related to disability and cognitive progression in multiple sclerosis
title_full Regional cerebellar atrophy related to disability and cognitive progression in multiple sclerosis
title_fullStr Regional cerebellar atrophy related to disability and cognitive progression in multiple sclerosis
title_full_unstemmed Regional cerebellar atrophy related to disability and cognitive progression in multiple sclerosis
title_short Regional cerebellar atrophy related to disability and cognitive progression in multiple sclerosis
title_sort regional cerebellar atrophy related to disability and cognitive progression in multiple sclerosis
topic Cerebellum
Structural MRI
Multiple sclerosis
Disability
Cognition
Atrophy
url http://www.sciencedirect.com/science/article/pii/S2213158225000622
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