Abstract| Volume 37, 101564, January 2020

Correlation between Central Nervous System Damage and Clinical Disability in a Sample of Egyptian Multiple Sclerosis Patients

      Multiple sclerosis (MS) is an autoimmune disease of the central nervous system that causes inflammatory as well as degenerative changes in the central nervous system. We aimed to study the correlation between clinical disability of the disease and advanced volumetric magnetic resonance imaging (MRI) parameter in a sample of Egyptian MS patients.
      Sixty MS patients and 63 age- and sex- matched healthy controls were recruited for the study. Clinical measures including Expanded Disability Status Scale (EDSS), 9-Hole Peg Test (9HPT), 25-Timed Foot Walking Test (25FWT), and Paced Auditory Serial Addition Test (PASAT) were used. 3D T1 MRI brain was acquired for measurement global as well as regional brain atrophy using FSL software; FLAIR sequence was used for brain lesion load estimation and STIR sequence was used for cervical spinal cord.
      Brain volume was significantly lower in MS patients compared to healthy controls. Progressive phenotypes showed lowest values compared to clinically isolated syndrome and relapsing remitting MS. High brain lesion load correlated with EDSS in Early-MS subgroup and no correlation to EDSS was found at Later-MS subgroup. High cervical lesion count was detected in the study group and cervical lesions showed significant correlation with clinical disability. Thalamic atrophy was present in Early-MS group compared to healthy controls, and thalamic volume correlated with clinical disability in this subgroup.
      Egyptian patients showed relatively similar disease characteristics to Western MS patients in terms of clinical and radiological parameters. Heavier cord lesion burden, and strong correlation between lesion load and clinical disability early in the disease may account for the relatively more aggressive disease course in Egyptian population. Thalamic atrophy occurs early in MS and may serve as a potential parameter in differentiating MS from other conditions.