Tabibian Farinaz, Hoseini Elahe, Motahharynia Ali, Azimzadeh Kiarash, Kafieh Raheleh, Amini Zahra, Adibi Iman
Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Mult Scler Relat Disord. 2025 Aug;100:106522. doi: 10.1016/j.msard.2025.106522. Epub 2025 May 13.
Corpus callosum (CC) is a key biomarker in multiple sclerosis (MS), with indices such as CC volume (CCV) and CC area (CCA) being correlated with disability and cognitive performance. However, discrepancies remain in the comparative associations of these indices and among MS phenotypes. A systematic search identified studies on MS patients, where CC size or volume measures were correlated with clinical outcomes, including Expanded Disability Status Scale (EDSS), Symbol Digit Modalities Test (SDMT), or Paced Auditory Serial Addition Test. The relationship between a CC index and a clinical outcome, where the correlation coefficient was reported in three or more studies, was synthesized using random-effects models. Risk of bias, reporting bias and certainty of analyses were evaluated. Subgroup analyses and meta-regression explored the heterogeneity. According to 35 included studies, among overall MS population, normalized CCV (nCCV) and CCA (nCCA) were the strongest correlates of EDSS (r = -0.383) and SDMT (r = 0.600), respectively, when controlling for demographic characteristics using partial correlation. Correlation of nCCA with EDSS was modulated by age (R^2 = 0.42), while it was absent in the study that included only relapsing-remitting MS (RRMS). In RRMS patients, significant association was observed between nCCV and EDSS (r = -0.429). Association between nCCV and SDMT (r = 0.226) was strengthened with increased disease duration (R^2 = 0.57) and in primary progressive MS patients (R^2 = 0.23). CCV reflects progression of disability in RRMS, whereas in progressive MS CCV marks cognitive decline and CCA could reflect the disability. This emphasizes the potential of CC indices to monitor the disease impact.
胼胝体（CC）是多发性硬化症（MS）的关键生物标志物，CC体积（CCV）和CC面积（CCA）等指标与残疾及认知表现相关。然而，这些指标的比较关联以及在MS各表型之间仍存在差异。一项系统检索确定了关于MS患者的研究，其中CC大小或体积测量值与临床结局相关，包括扩展残疾状态量表（EDSS）、符号数字模态测验（SDMT）或听觉连续加法测验。使用随机效应模型综合了在三项或更多研究中报告了相关系数的CC指标与临床结局之间的关系。评估了偏倚风险、报告偏倚和分析的确定性。亚组分析和meta回归探讨了异质性。根据纳入的35项研究，在总体MS人群中，使用偏相关控制人口统计学特征时，标准化CCV（nCCV）和CCA（nCCA）分别是与EDSS（r = -0.383）和SDMT（r = 0.600）相关性最强的指标。nCCA与EDSS的相关性受年龄调节（R² = 0.42），而在仅纳入复发缓解型MS（RRMS）的研究中未观察到这种相关性。在RRMS患者中，观察到nCCV与EDSS之间存在显著关联（r = -0.429）。nCCV与SDMT之间的关联（r = 0.226）随着疾病持续时间的增加（R² = 0.57）以及在原发性进展型MS患者中（R² = 0.23）而增强。CCV反映RRMS中残疾的进展，而在进展型MS中，CCV标志着认知下降，CCA可能反映残疾情况。这强调了CC指标监测疾病影响的潜力。
