The following is a summary of “Conventional MRI-Based Structural Disconnection and Morphometric Similarity Networks and Their Clinical Correlates in Multiple Sclerosis,” published in the January 2025 issue of Neurology by Tranfa et al. 

Multiple sclerosis (MS) is a network disorder, but brain network analyses usually require advanced MRI sequences. Conventional MRI was used to assess structural disconnection and morphometric similarity networks in people with MS (pwMS), along with their link to clinical disability. 

Researchers conducted a retrospective study to assess structural disconnection and morphometric similarity networks in pwMS using conventional MRI.  

They analyzed 3T MRI data from pwMS and healthy controls (HC), assessing disabilities using expanded disability status scale (EDSS) and symbol digit modalities test (SDMT). Demyelinating lesions were segmented, structural disconnection was evaluated with normative tractography, and morphometric similarity was computed via FreeSurfer. Network-based statistics (NBS) and NBS-predict tested the association between connectomes and disease status, progression, and confirmed disability progression (CDP), independent of lesion burden and atrophy. 

The results showed that 461 pwMS (age = 37.2 ± 10.6 years, F/M = 324/137) and 55 HC (age = 42.4 ± 15.7 years, F/M = 25/30) were studied. Long-term follow-up was available for 285 pwMS (mean follow-up time = 12.4 ± 2.8 years), with 127 (44.6%) exhibiting CDP. At baseline, pwMS showed structural disconnection around the thalami and cortical sensory and association hubs, with disrupted morphometric similarity (pFWE < 0.01). EDSS was related to frontothalamic disconnection (pFWE < 0.01) and disrupted morphometric similarity around the left perisylvian cortex (pFWE = 0.02). SDMT was associated with cortico-subcortical disconnection in the left hemisphere (pFWE < 0.01). Longitudinally, both structural disconnection and morphometric similarity disruption progressed (pFWE = 0.04 and pFWE < 0.01), correlating with EDSS increase (P = 0.07, P = 0.02 and P = 0.11, P < 0.001). Baseline disconnection predicted long-term CDP (accuracy = 59% [58–60], P = 0.03). 

Investigators demonstrated that structural disconnection and morphometric similarity networks, assessed with conventional MRI, were sensitive to brain damage in MS. These networks predicted clinical disability and long-term disease progression independently from global lesion burden and atrophy. 

Source: neurology.org/doi/10.1212/WNL.0000000000213349