Volumetric assessment of hypothalamus in relapsing–remitting multiple sclerosis

Abstract

Abstract Background Multiple sclerosis is the most common neurodegenerative disorder worldwide. Autonomic manifestations are commonly reported in multiple sclerosis patients including sleep disturbance, depressive episodes, chronic fatigue, weight changes and unexplained temperature swings. Relation between hypothalamus and MS has been infrequently studied owing to the small size of the hypothalamus which made this territory out of researcher’s reach. However, new advances in the field of volumetry are recently emerging promising us to discover this long-neglected vital structure in our brain. Aim of study The aim of the study was to determine the total volume of hypothalamus and its relationship with total demyelinating lesion volume (TLV) and autonomic symptoms reported in relapsing–remitting multiple sclerosis (RRMS) patients. Methods A case–control study was conducted over the course of 6 months from 1st of March 2024 till 1st of September 2024. It included 36 RRMS patients and 36 healthy controls. Volumetric assessment of the hypothalamus was performed, through fully automatic analysis techniques, using volumetric 3D T1 images obtained for both groups. Results We noted a statistically significant reduction in the total volume of hypothalamus in RRMS group (test value = 2.483, p = 0.015). TLV correlates negatively with total volume of hypothalamus (r = − 0.649, p < 0.001). Hypothalamic symptoms show negative correlation to total volume of the hypothalamus (r = − 0.662, p < 0.001). Conclusion Our study revealed a reduction in total volume of hypothalamus in RRMS patients. The total volume of hypothalamus was negatively correlated to TLV and autonomic symptoms investigated in our patients. By proving this relationship, we hope to offer an explanation for the various autonomic symptoms frequently reported in MS patients, thus enabling further research into targeted treatment modalities which would dramatically improve their quality of life.