Relationship Between Bi-Caudate Ratio and White Matter Atrophy in Brain MRI of Multiple Sclerosis

Background: Multiple sclerosis (MS) is one of the most common and debilitating neurological diseases. Brain magnetic resonance imaging (MRI) is critical to determine the prognosis of MS. Using simple and accessible techniques is one of the researchers concerns. So far, limited studies have been conducted on evaluating the relationship between the Bi-caudate ratio (BCR) and white matter atrophy in brain MRI of patients with MS. Therefore, in this study, we decided to evaluate this relationship. Materials and Methods: In this cross-sectional study, which was conducted to determine the relationship between BCR and white matter atrophy in brain MRI patients with MS, patients with MS who were evaluated by MRI at Imam Hossein Hospital (Tehran-Iran) in 2022 were assessed. BCR is determined by dividing the shortest distance between two caudate nuclei by the length of the brain at the imaging. The symbol digit modalities test (SDMT) was used to check the cognitive function of patients, and the relationship between BCR and MS-related parameters was evaluated. Expanded disability status score (EDSS) was also evaluated. A significance level was considered less than 0.05. Results: Eighty-five patients with a mean age of 40.73 ± 8.45 years and female gender was more prevalent (65.9%). The mean EDSS in all participants was 2.64 ± 2.49, and the mean BCR was 0.11 ± 0.03. EDSS score, age of the disease onset, SDMT score, and BCR were significantly different between different MS types (secondary progressive MS, primary progressive MS, and relapsing-remitting MS) (P-values 0.05). There was a statistically significant relationship between age, disease duration, EDSS score, onset age of the disease, and SDMT score with BCR (P 0.05). There was a statistically significant difference in the amount of BCR between sexes (P 0.045). Conclusion: BCR is a valuable method for evaluating the condition of multiple sclerosis, and it can be used as a simple and accessible technique for evaluating MS conditions.