Analysis of the extent of limbic system changes in multiple sclerosis using FreeSurfer and voxel-based morphometry approaches

Background and Purpose: The limbic brain is involved in diverse cognitive, emotional, and autonomic functions.  Injury of the various parts of the limbic system have been correlated with clinical deficits in MS.  The purpose of this study was to comprehensively examine different regions of the subcortical limbic system to assess the extent of damage within this entire system as it may be pertinent in correlating with specific aspects of cognitive and behavioral dysfunction in MS by using a fully automated, unbiased segmentation approach. 
Results: The mean [95% confidence interval] of the total limbic system volume was lower (0.22% [0.21-0.23]) in MS compared to healthy controls (0.27%, [0.25-0.29], p < .001).  Pairwise comparisons of individual limbic regions between MS and controls was significant in the nucleus accumbens (0.046%, [0.043-0.050]  vs. 0.059%, [0.051-0.066],  p = .005), hypothalamus  (0.062%, [0.059-0.065] vs. 0.074%, [0.068-0.081], p = .001), basal forebrain (0.038%,...