# AI-driven MRI analysis reveals brain atrophy patterns in benign relapsing-remitting multiple sclerosis

## TL;DR

AI analysis of MRI scans shows specific brain atrophy patterns in patients with benign relapsing-remitting multiple sclerosis compared to healthy individuals.

## Contribution

This study identifies distinct brain atrophy patterns in benign relapsing-remitting MS using AI-driven MRI analysis.

## Key findings

- Total brain tissue volume was significantly smaller in BRRMS patients compared to healthy controls.
- Cortical and cerebral gray matter volumes, along with cingulate gyrus and entorhinal area volumes, were larger in BRRMS.
- The corpus callosum index and area were significantly smaller in BRRMS patients.

## Abstract

The existence and definition of benign multiple sclerosis (MS) remain controversial, particularly given the discrepancy between clinical presentation and underlying imaging changes. In this study, we aimed to investigate the brain atrophy patterns related to benign relapsing-remitting MS (BRRMS), particularly regarding location and extent.

We analyzed global and regional gray matter (GM) and white matter (WM) volumes, WM lesion load, corpus callosum index (CCI) and corpus callosum area (CCA) in well-defined benign relapsing-remitting MS patients (BRRMS, n = 35) compared to healthy controls (HC, n = 35). Imaging data were analyzed using an AI-based volumetric analysis MRI (cNeuro®) and confirmed visually by an experienced neuroradiologist, ensuring robust validation.

Total brain tissue volume was significantly smaller in patients with BRRMS compared to HC (p < 0.001), but the cortical (p = 0.011) and cerebral (p = 0.002) GM volumes, as well as cingulate gyrus (p=0.032) and entorhinal area volumes (p < 0.001), were larger in BRRMS. GM volumes in the postcentral gyrus (p = 0.001), precentral gyrus (p < 0.001), the medial segment of the precentral gyrus (p < 0.001), supplementary motor cortex (p < 0.001) and thalamus (p < 0.001) were reduced in BRRMS compared to HC. Furthermore, both CCI and CCA were significantly smaller in BRRMS (p < 0.001 and p = 0.001, respectively).

Despite the overall reduced brain volume compared to HC, distinct cortical regions, especially within the limbic system (i.e., cingulate gyrus and entorhinal area) GM may be relatively well preserved, indicating a possible compensatory volume increase. Based on this study, the corpus callosum is a crucial structure in monitoring disease progression in BRRMS.