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. 2014 May 2;9(5):e96193.
doi: 10.1371/journal.pone.0096193. eCollection 2014.

The clinical impact of cerebellar grey matter pathology in multiple sclerosis

Alfredo Damasceno  1 , Benito Pereira Damasceno  1 , Fernando Cendes  1
Affiliations

The clinical impact of cerebellar grey matter pathology in multiple sclerosis

Alfredo Damasceno et al. PLoS One. .

Abstract

Background: The cerebellum is an important site for cortical demyelination in multiple sclerosis, but the functional significance of this finding is not fully understood.

Objective: To evaluate the clinical and cognitive impact of cerebellar grey-matter pathology in multiple sclerosis patients.

Methods: Forty-two relapsing-remitting multiple sclerosis patients and 30 controls underwent clinical assessment including the Multiple Sclerosis Functional Composite, Expanded Disability Status Scale (EDSS) and cerebellar functional system (FS) score, and cognitive evaluation, including the Paced Auditory Serial Addition Test (PASAT) and the Symbol-Digit Modalities Test (SDMT). Magnetic resonance imaging was performed with a 3T scanner and variables of interest were: brain white-matter and cortical lesion load, cerebellar intracortical and leukocortical lesion volumes, and brain cortical and cerebellar white-matter and grey-matter volumes.

Results: After multivariate analysis high burden of cerebellar intracortical lesions was the only predictor for the EDSS (p<0.001), cerebellar FS (p = 0.002), arm function (p = 0.049), and for leg function (p<0.001). Patients with high burden of cerebellar leukocortical lesions had lower PASAT scores (p = 0.013), while patients with greater volumes of cerebellar intracortical lesions had worse SDMT scores (p = 0.015).

Conclusions: Cerebellar grey-matter pathology is widely present and contributes to clinical dysfunction in relapsing-remitting multiple sclerosis patients, independently of brain grey-matter damage.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Cerebellar intracortical and leukocortical lesions.
Axial double inversion recovery images from relapsing-remitting MS patients showing intracortical (long arrows, A and B) and leukocortical lesions (short arrows, C and D).
Figure 2
Figure 2. Burden of cerebellar intracortical lesions and clinical/cognitive outcomes.
Box plots comparing patients with high and low burden (> 0.05 cm3 or<0.05 cm3) of cerebellar intracortical lesions on clinical (A – D) and cognitive outcomes (E, F).
See this image and copyright information in PMC

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