Research News

How does neurodegeneration in MS patients change as they age?

Multiple views of an MRI of a 72-year-old female patient with multiple sclerosis (A) demonstrates pathology in the white matter and ventricular enlargement, both of which are typical of MS, whereas the MRI of a 73-year-old female patient with Alzheimer’s disease (B) demonstrates significant cortical thinning (as shown and compared in the red rectangles), which is greater in Alzheimer’s disease.

By ELLEN GOLDBAUM

“As the first of its kind, our study may increase the awareness of a potential Alzheimer’s-associated pathology among MS patients. ” Robert Zivadinov, professor of neurology and director Buffalo Neuroimaging Analysis Center

Neurodegeneration results from a number of neurological conditions affecting older adults, including Alzheimer’s disease and Parkinson’s disease. Treating such diseases is challenging enough, but in recent years, the increased longevity of patients with multiple sclerosis, which also causes neurodegeneration and brain atrophy, has highlighted the need to understand the differences among these neurological conditions. Now, UB researchers have published in the journal Neurobiology of Aging the first study that compares brain changes among age-matched healthy controls and older patients who have MS, Alzheimer’s, Parkinson’s or amnestic mild cognitive impairment, which primarily affects only memory. The paper was published online Feb. 8.

Patterns of brain atrophy

“This study is a first step in comparing patterns of brain atrophy and determining which brain regions are vulnerable and may accelerate during the aging process,” says Dejan Jakimovski, first author and an MD-PhD candidate in the neuroscience program at the Jacobs School of Medicine and Biomedical Sciences at UB. “Given that cognitive decline is a symptom of MS, Alzheimer’s disease, Parkinson’s disease and amnestic mild cognitive impairment, we are using magnetic resonance imaging to begin to uncover some structural features that may distinguish how this symptom develops in these different diseases,” he explains. Over 400 people participated in the study, nearly half of whom were healthy controls; more than a quarter were MS patients and the rest had Alzheimer’s, Parkinson’s or amnestic mild cognitive impairment. All underwent structural magnetic resonance imaging, which non-invasively reveals the anatomy and pathology of the brain.

Newly emerging cognitive deficits

“One of the goals of the study was to identify certain structural MRI features that could help us better understand the newly emerging cognitive deficits seen in aging MS patients,” Jakimovski says. He notes that as they age, MS patients with progressive disease experience daily difficulties with cognitive functioning and, as their neurodegeneration accelerates, their cognitive difficulties may worsen. “Therefore, greater awareness of their cognitive abilities and the risk for future decline indicate that MS patients need baseline cognitive and MRI testing. They should also communicate with their neurologists and neuropsychologists about cognitive changes that they notice.” The researchers weren’t surprised to find that the most significant factor that differentiated the brains of MS patients from other participants was the extent of white matter volume atrophy. “Pathology within the white matter of the brain is specific to MS patients,” explains Robert Zivadinov, senior author, professor of neurology in the Jacobs School and director of its Buffalo Neuroimaging Analysis Center (BNAC) and the Center for Biomedical Imaging at UB’s Clinical and Translational Science Institute. “These inflammatory lesions affect the axons, the brain’s main highways for information, and their disruption significantly decreases the speed and efficacy of information processing.” He adds that the cognitive function most commonly associated with the progression of MS is the slowing down of cognitive processing, the ability to efficiently accomplish a mental task.

Brain volume in MS similar to Alzheimer’s