Article Text

Download PDFPDF
Sex hormones modulate brain damage in multiple sclerosis: MRI evidence
  1. V Tomassini1,
  2. E Onesti1,
  3. C Mainero1,
  4. E Giugni1,
  5. A Paolillo1,
  6. M Salvetti1,
  7. F Nicoletti2,
  8. C Pozzilli1
  1. 1Department of Neurological Sciences, “La Sapienza” University, Rome, Italy
  2. 2Department of Pharmacology, “La Sapienza” University, Rome, and INM Neuromed, Pozzilli, Italy
  1. Correspondence to:
 Professor Carlo Pozzilli
 Department of Neurological Sciences, II Faculty of Medicine, University “La Sapienza”, viale dell’Università 30, 00185 Rome, Italy;


Background: Sex related differences in the course and severity of multiple sclerosis (MS) could be mediated by the sex hormones.

Objective: To investigate the relation between serum sex hormone concentrations and characteristics of tissue damage on conventional magnetic resonance imaging (MRI) in men and women suffering from relapsing-remitting MS.

Results: Serum testosterone was significantly lower in women with MS than in controls. The lowest levels were found in women with a greater number of gadolinium enhancing lesions. A positive correlation was observed between testosterone concentrations and both tissue damage on MRI and clinical disability. In men, there was a positive correlation between oestradiol concentrations and brain damage.

Conclusions: The hormone related modulation of pathological changes supports the hypothesis that sex hormones play a role in the inflammation, damage, and repair mechanisms typical of MS.

  • DHEAs, dehydroepiandrosterone sulphate
  • EDSS, expanded disability status scale
  • FSH, follicle stimulating hormone
  • Gd, gadolinium
  • LH, luteinising hormone
  • RRMS, relapsing-remitting multiple sclerosis
  • sex hormones
  • brain damage
  • MRI
  • multiple sclerosis

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: none declared