Gray matter metabolic changes and atrophy in multiple sclerosis correspond to neurotransmitter maps

Motivation: A clearer understanding of metabolic abnormalities and irreversible damage in brain would provide valuable insights into the pathophysiology of multiple sclerosis (MS). Goal(s): To explore gray matter (GM) sodium accumulation and atrophy in MS by 23Na-MRI and 1H-MRI. Approach: The differences in total sodium concentration (TSC) and volume were compared between MS and healthy controls (HC). Spatial correlations between the differences of regional TSC or volume and neurotransmitter maps were investigated using JuSpace toolbox. Results: Sodium accumulation occurs primarily in cortical regions of MS, whereas atrophy occurs mostly in subcortical regions. Regional GM damage with specific neurotransmitter systems is associated with clinical manifestations. Impact: We illustrated the important role of altered sodium concentration in the pathophysiological mechanisms of MS and provided new insights into the relationship between GM metabolic alteration and irreversible neuronal loss and neurotransmission function.