Corpus callosum MRI study in multiple sclerosis and small vessel ischemic stroke

ABSTRACT

Damage to corpus callosum visible by MRI in multiple sclerosis may be simulated by other CNS diseases [e.g. ischemia, SLE, Behcet's disease, other vasculitides, sarcoidosis]. Ischemic lesions, in particular, make MRI criteria much less reliable for the diagnosis of MS pateints over the age of 50. To study the difference between MRI abnormalities of the corpus callosum in patients with MS versus small vessel ischemic stroke. 76 patients were divided into 2 groups group 1, comprising 26 patients with clinically definite, relapsing remitting, MS; and group 2, including 50 hypertensive and /or diabetic patients with history and clinical evidence of ischemic stroke proved by MRI to be of small vessel ischemic type. They were all subjected to minimental state examination [MMSE] and MRI brain study for corpus callosum lesions and atrophy. The mean MMSE score in the stroke group was 27.75 +/- 3.21 while in the MS group it was 23.62 +/- 3.76 with a significant difference between them [P < 0.05]. In both groups, the score inversely correlated with corpus callosum atrophy. The latter was significantly more in MS group [X[2] = 47.045, P <0.05]. The mean number of corpus callosum lesions was 2.3 +/- 2.4 in the stroke group and 8.1 +/- 2.6 in MS group with significant difference [P<0.05]. The predilection of location of corpus callosum lesions was significantly different in the 2 groups [P<0.05], being more inner callosal [42%] and ventriculocallosal [49%] in MS group while the outer callosal was more common in the stroke group [35%]. Corpus callosum atrophy would be used as a relatively morphological marker for cognitive decline in MS and small vessel ischemic stroke, being significantly more in MS. The more atrophic the corpus callosum is, the more weighing down of MS versus small vessel ischemic stroke in clinically and radiologically overlapping cases