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Magnetic resonance evidence of cerebellar cortical pathology in multiple sclerosis
  1. Massimiliano Calabrese1,
  2. Irene Mattisi1,
  3. Francesca Rinaldi1,
  4. Alice Favaretto1,
  5. Matteo Atzori1,
  6. Valentina Bernardi1,
  7. Luigi Barachino2,
  8. Chiara Romualdi3,
  9. Luciano Rinaldi1,
  10. Paola Perini1,
  11. Paolo Gallo1
  1. 1The Multiple Sclerosis Centre of Veneto Region—First Neurology Clinic, Department of Neurosciences, University Hospital of Padua, Padua, Italy
  2. 2Neuroradiology Unit, Euganea Medica, Albignasego, Padua, Italy
  3. 3CRIBI—Biotechnology Centre and Department of Biology, University of Padua, Padua, Italy
  1. Correspondence to Dr Massimiliano Calabrese, Multiple Sclerosis Centre of Veneto Region, First Neurology Clinic, Department of Neurosciences, University Hospital of Padova, Via Giustiniani 3, 35128 Padua, Italy; calabresem{at}


Background Although neuropathological observations suggest that cerebellar cortex is a major site of demyelination in multiple sclerosis (MS), only a few MRI studies on cerebellar cortical pathology in MS are available.

Objective To analyse cerebellar cortical volume (CCV) and leucocortical lesions (CL) in MS, and their impact on clinical disability.

Methods The authors studied 125 patients divided into 38 Clinical Isolated Syndrome (CIS), 35 relapsing remitting multiple sclerosis (RRMS), 27 secondary progressive multiple sclerosis (SPMS) and 25 primary progressive multiple sclerosis, and 32 normal controls (NC). CCV and cerebellar CL number and volume were evaluated by means of Freesurfer software and Double Inversion Recovery, respectively.

Results Compared with NC (mean 113.2±2.6 cm3), the CCV was significantly reduced in CIS (105.4±2.2 cm3, p=0.018), RRMS (104.0±2.0 cm3, p=0.012), SPMS (98.8±2.0 cm3, p<0.001) and PPMS (100.6±2.2 cm3, p<0.001), even after age, gender and mean cortical volume correction. CL were observed in all patient groups and were an independent predictor of CCV and cerebellar dysfunction.

Discussion The authors confirm that the cerebellar cortex is severely and early affected by MS pathology. The monitoring of cerebellar cortical atrophy and CL may help to understand the mechanism underlying disability progression in MS.

  • multiple sclerosis
  • cerebellum
  • grey matter pathology
  • MRI

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  • Competing interests None.

  • Ethics approval Ethics approval was provided by the University Hosptial of Padua.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.