Structural MRI findings in MS and other comorbid neuropsychiatric conditions
| Study group | Patient group |
MRI Scanner, slices (mm), method | Psychometric instruments | Disability status | Findings | ||
| MS | MS+comorbid psychiatric disorder | Healthy controls | |||||
| Ron and Logsdail (1989)83 | 116 | 50/116 (adjustment D/O=22, depression=12 bipolar D/O=5, delusional D/O=4, atypical psychosis=3, anxiety D/O=2, organic disorder=1) | 40 HC 48 PD (11=arthritic condition, 37=neurological condition with no brain involvement) (depression=5, adjustment D/O=3) | 0.5 T superconducting system Scanner, 10 mm slices with 2 mm gap, radiological evaluation of lesions | BDI CIS SSSI MMSE | — | Elation correlated with widespread MRI abnormalities. Pathology in temporo-parietal region correlated with flattened affect, delusions and thought disorder |
| Feinstein et al (1992)84 | 10 | 10 (mania with psychosis) |
- | 0.5 T Picker Scanner, 5 mm slices, radiological evaluation of lesions | PSE SCL | Mean EDSS=4.9 | Trends reported for greater total lesions in left trigone and areas surrounding the third ventricle in group with psychosis. The psychosis group had a higher total lesion score and greater lesions in periventricular areas, predominantly around the temporal horn. Neurological symptoms preceded onset of psychosis No significant correlations were found between individual psychotic symptoms and site of MRI lesions |
| Feinstein et al (1992)131 | 19 (RR=12, CP=7) CIL=16 | 3/35 individuals had comorbid psychiatric disorders (1=psychosis, 2=euphoria) | 30 | 0.5 T Picker Scanner, 5 mm slices Radiological evaluation of lesions | CIS HADS SSSI | Mean EDSS=3.5 | No significant findings with quantitative lesion score and psychiatric status |
| Diaz-Olavarrieta et al (1999)124 | 44 | 42/45 had symptoms on NPI (dysphoria=79%, agitation=40%, anxiety=37%, apathy=20%, euphoria=13%, irritability=13%, hallucinations=10%) | 25 (84% had no symptoms based on the NPI) | Gadolinium-enhanced MR images Radiological evaluation of lesions | MMSE NPI | Mean EDSS=3.3 | Only euphoria and hallucinations correlated with the severity of demyelination |
| Benedict et al (2004)123 | 37 (RR=30, SP=7) | 31/37 had NPI administered | — | 1.5 T Philips Gyroscan Scanner, 5 mm slices | NPI | Mean EDSS=2.5 | Euphoria, depression and agitation were correlated with lesion volume, and euphoria was correlated with global brain atrophy; however, these correlations were non-significant when cognitive function was controlled for |
| Ghaffar et al (2008)112 | 14 (RR=7, SP=5, PP=2) | 14 PBA (RR=3, SP=7, PP=4) | — | 1.5 T Sigma Systems, GE Scanner, 1.2–1.4 mm slices, lesion analysis, measurement of GM, WM, CSF | — | Mean EDSS in PBA=6.0 and in MS alone=4.6 (p=0.08) | Increased brain lesions in the brainstem, left inferior parietal lobe, and left and right medial and inferior frontal lobes. No difference in brain atrophy between the groups. |
BDI, Beck Depression Inventory; CIL, clinically isolated lesions; CIS, Clinical Interview Schedule; CP, chronic progressive; CSF, cerebrospinal fluid; D/O, disorder; EDSS, Expanded Disability Scale; GM, grey matter; HADS, Hospital Anxiety and Depression Scale; HC, healthy controls; HDRS, Hamilton Depression Rating Scale; MADRS, Montgomery and Asberg Depression Scale; MMSE, Mini-Mental State Examination; MS, multiple sclerosis; NPI, Neuropsychiatric Inventory; PBA, pseudobulbar affect; PSE, Present State Examination; RR, relapse remitting; SAS, Zung Self-rated Anxiety Scale; SDS, Zung Self-rated Depression Scale; SSSI, Social Stress and Support Interview; WM, white matter.