Neuroimaging markers and disability scales in multiple sclerosis: A systematic review and meta-analysis

Abstract

Background Multiple sclerosis (MS) is a central nervous system disorder marked by progressive neurological impairments. Magnetic resonance imaging (MRI) parameters are key paraclinical measures that play a crucial role in the diagnosis, prognosis, and monitoring of MS-related disability. This study aims to analyze and summarize the existing literature on the correlation between MRI parameters and disability in people with MS (pwMS). Methods The PubMed/MEDLINE, Embase, Scopus, and Web of Science databases were searched from inception to July 19, 2024, and a meta-analysis was carried out using R software version 4.4.0 and the random effects model used to determine the pooled correlation coefficient, with its 95 confidence interval (CI), between MRI measurements and disability scales. Results Among 5741 studies, 383 studies with 39707 pwMS were included. The meta-analysis demonstrated that Expanded Disability Status Scale (EDSS) had significant correlations with cervical cord volume (r = -0.51, 95 CI: -0.62 to -0.38, I-2 = 0, p-heterogeneity = 0.86, p-value<0.01), cortical lesion volume (r = 0.45, 95 CI: 0.36 to 0.53, I-2 = 68, p-heterogeneity<0.01, p-value<0.01), brain volume (r = -0.40, 95 CI: -0.47 to -0.33, I-2 = 41, p-heterogeneity = 0.05, p-value<0.05), and grey matter volume (GMV) (r = -0.36, 95 CI: -0.49 to -0.21, I-2 = 0, p-heterogeneity = 0.53, p-value<0.01), respectively. Conclusion This study offers evidence suggesting that cortical lesion volume, brain volume, GMV, and MRI measurements of the spinal cord may constitute reliable indicators for assessing disability in pwMS.