Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2015, vol. 21, issue 4
Subject Area: Medicine
Pages: 1015-1018
DOI: 10.5272/jimab.2015214.1015
Published online: 29 December 2015

J of IMAB 2015 Oct-Dec;21(4):1015-1018
Ivan Dimitrov 1Corresponding Autor, Radoslav Georgiev2, Ara Kaprelyan3, Nataliya Usheva4, Margarita Grudkova3, Kalina Drenska3, Borislav Ivanov5
1) Department of Nursing, Medical University, Varna, Sliven Affiliate.
2) Department of Imaging Diagnostics and Radiotherapy, Medical University, Varna
3) Department of Neurological Diseases and Neuroscience, Medical University, Varna
4) Department of Social Medicine and Organization of Healthcare, Medical University, Varna
5) Department of Clinical Medical Sciences, Dental Faculty, Medical University, Varna, Bulgaria.

Background: Demyelination and neurodegeneration are hallmarks of multiple sclerosis (MS). Axonal damage is considered to be the leading factor for persisting disability in the course of the disease. In different studies, expanded disability status scale (EDSS) scores have been found to correlate with brain atrophy, lesion load, or both.
Objective: To assess the possible correlations between EDSS scores and volumes of brain, grey and white matter, and subcortical structures in patients with relapsing-remitting multiple sclerosis.
Subjects and Methods: 46 patients with RRMS were included in the study. Total brain volume, grey and white matter volumes were calculated using SIENAX, and subcortical structure volumes were obtained using FIRST, parts of FSL. EDSS was scored by a qualified rater. Statistical analysis was performed.
Results: Moderate negative correlation of EDSS was demonstrated with total brain volume, grey and white matter volume, volumes of left and right pallidum, putamen, caudate nucleus, n. accumbens (p<0.01), and with the volumes of left and right thalamus (p<0.05). Moderate positive correlation was found between EDSS and T2 lesion volume (p<0.01). Correlation between EDSS and hippocampal volumes was weak.
Our results demonstrate that in patients with relapsing-remitting multiple sclerosis, higher disability correlates with lower volumes of brain, grey and white matter, and some subcortical structures, but also with higher T2 lesion load. We support the hypothesis about a possible causal relationship between white matter damage and brain atrophy, as well as the role of both demyelination and neurodegeneration for disability in MS.

Key words: multiple sclerosis, EDSS, volumetric study, lesion load,

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Please cite this article in PubMed Style or AMA (American Medical Association) Style:
Dimitrov I, Georgiev R, Kaprelyan A, Usheva N, Grudkova M, Drenska K, Ivanov B. Brain and Lesion Volumes Correlate with EDSS in Relapsing-Remitting Multiple Sclerosis. J of IMAB. 2015 Oct-Dec;21(4):1015-1018. doi:

Correspondence to: Ivan Dimitrov, MD, PhD; First Clinic of Neurology, Sveta Marina University Hospital; 1, Hristo Smirnenski str., 9010 Varna, Bulgaria; E-mail:

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Received: 10 July 2015
Published online: 29 December 2015

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