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Abstract Details

Pregnancy is Associated with Accelerated Atrophy in Key Social Processing Brain Regions in Women with MS
Multiple Sclerosis
P9 - Poster Session 9 (11:45 AM-12:45 PM)
1-011
To evaluate volumetric changes associated with pregnancy in the brains of women with multiple sclerosis (WwMS).

In the general population, brain volume decreases are reported after pregnancy, including in gray matter structures relating to social processing. Such changes are not well characterized in WwMS, who may experience postpartum inflammatory activity and neurogenerative changes.
From an observational MS pregnancy registry, n=33 WwMS  identified to have at least one brain MRI in both the pre-pregnancy (0-12M) and post-live birth (0-3 years) phases, using similar acquisition protocols. These individuals (P-WwMS) were manually matched (by age, interval between MRIs, acquisition protocol) with 33 non-pregnant (NP-WwMS) participants in an ongoing observational study. Two validated pipelines, FreeSurfer and FastSurfer, were utilized to measure regional brain volumes, focusing on four social processing regions. Changes (percent and absolute) between the two timepoints were compared between the P- and NP- cohorts using paired t-tests.
The cohorts did not differ in age, race/ethnicity, MS type or duration (p>0.05 each). P-WwMS experienced significantly greater % reductions in volume in the hippocampus (p=0.0029), fusiform gyrus (p=0.017), and anterior cingulate cortex (p=0.018). Evaluating absolute changes across both processing pipelines revealed similar findings, in all four regions of interest including the inferior frontal gyrus (p=0.0105), and multiple exploratory structures. P-WwMS also experienced more inflammatory activity (T2 lesions) and tissue destruction within lesions (T1 hypointensities) (p<0.05 each). However, the observed differences between cohorts in the four social processing areas remained significant after adjusting for these (p<0.05 each).

WwMS who had a pregnancy experienced accelerated volume loss across key structures associated with social processing, consistent with the general population. These changes remained, after accounting for MS-related factors (inflammatory activity, T1 hypointensities). Possible underlying mechanisms—including atrophy, pruning, or resolution of inflammation—require further analysis to better inform considerations around pregnancy-planning in WwMS.
Authors/Disclosures
Ayushi D. Balan (UCSF)
PRESENTER 		Miss Balan has nothing to disclose.
Amit Akula (University of California, San Francisco) Amit Akula has nothing to disclose.
Annika Anderson (UCLA David Geffen School of Medicine) Miss Anderson has nothing to disclose.
Stephanie Hsu Stephanie Hsu has nothing to disclose.
Manula Dombagahawatta Mr. Dombagahawatta has nothing to disclose.
Haojun Zhao (UCSF) HAOJUN ZHAO has nothing to disclose.
Roland G. Henry, PhD (University of California, San Francisco) Dr. Henry has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MEDDAY. Dr. Henry has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Henry has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Henry has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi/Genzyme.
Riley Bove, MD, FAAN (University of California, San Francisco) Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion. Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amgen. Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genzyme-Sanofi. Dr. Bove has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for TG Therapeutics. Dr. Bove has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD-Serono. Dr. Bove has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cadenza. The institution of Dr. Bove has received research support from Biogen. The institution of Dr. Bove has received research support from Eli Lilly. The institution of Dr. Bove has received research support from Novartis. The institution of Dr. Bove has received research support from Roche Genentech.