No study has investigated red nucleus (RN) atrophy in multiple sclerosis (MS) despite cerebellum and its connections are elective sites of MS‐related pathology. In this study, we explore RN atrophy in early MS phases and its association with cerebellar damage (focal lesions and atrophy) and physical disability. Thirty‐seven relapse‐onset MS (RMS) patients having mean age of 35.6 ± 8.5 (18–56) years and mean disease duration of 1.1 ± 1.5 (0–5) years, and 36 age‐ and sex‐matched healthy controls (HC) were studied. Cerebellar and RN lesions and volumes were analyzed on 3 T‐MRI images. RMS did not differ from HC in cerebellar lobe volumes but significantly differed in both right (107.84 ± 13.95 mm³ vs. 99.37 ± 11.53 mm³, p = .019) and left (109.71 ± 14.94 mm³ vs. 100.47 ± 15.78 mm³, p = .020) RN volumes. Cerebellar white matter lesion volume (WMLV) inversely correlated with both right and left RN volumes (r = −.333, p = .004 and r = −.298, p = .010, respectively), while no correlation was detected between RN volumes and mean cortical thickness, cerebellar gray matter lesion volume, and supratentorial WMLV (right RN: r = −.147, p = .216; left RN: r = −.153, p = .196). Right, but not left, RN volume inversely correlated with midbrain WMLV (r = −.310, p = .008), while no correlation was observed between whole brainstem WMLV and either RN volumes (right RN: r = −.164, p = .164; left RN: r = −.64, p = .588). Finally, left RN volume correlated with vermis VIIb (r = .297, p = .011) and right interposed nucleus (r = .249, p = .034) volumes. We observed RN atrophy in early RMS, likely resulting from anterograde axonal degeneration starting in cerebellar and midbrain WML. RN atrophy seems a promising marker of neurodegeneration and/or cerebellar damage in RMS.

中文翻译：

---

复发性多发性硬化症早期红核萎缩

尽管小脑及其连接是 MS 相关病理的选择性部位，但没有研究调查多发性硬化症 (MS) 中的红核 (RN) 萎缩。在这项研究中，我们探讨了 MS 早期阶段的 RN 萎缩及其与小脑损伤（局灶性病变和萎缩）和身体残疾的关联。37 名复发性 MS (RMS) 患者，平均年龄为 35.6 ± 8.5 (18-56) 岁，平均病程为 1.1 ± 1.5 (0-5) 年，以及 36 名年龄和性别匹配的健康对照（ HC) 进行了研究。在 3 张 T-MRI 图像上分析小脑和 RN 病变和体积。RMS 在小脑叶体积方面与 HC 没有区别，但在右侧（107.84 ± 13.95 mm ³与 99.37 ± 11.53 mm ³，p  = .019）和左侧（109.71 ± 14.94 mm）中均存在显着差异³与 100.47 ± 15.78 mm ³，p  = .020) RN 体积。小脑白质病变体积 (WMLV) 与左右 RN 体积呈负相关（分别为r  = -.333，p  = .004 和r  = -.298，p  = .010），而未检测到 RN 之间的相关性体积和平均皮质厚度、小脑灰质病变体积和幕上 WMLV（右侧 RN：r  = -.147，p  = .216；左侧 RN：r  = -.153，p  = .196 ）。右侧，但不是左侧，RN 体积与中脑 WMLV 呈负相关（r  = -.310，p = .008)，而在整个脑干 WMLV 与任一 RN 体积之间未观察到相关性（右侧 RN：r  = -.164，p  = .164；左侧 RN：r  = -.64，p  = .588）。最后，左侧 RN 体积与 vermis VIIb ( r  = .297, p = .011) 和右侧插入核 ( r  = .249, p  = .034) 体积相关。我们在早期 RMS 中观察到 RN 萎缩，这可能是从小脑和中脑 WML 开始的顺行轴索变性引起的。RN 萎缩似乎是 RMS 中神经变性和/或小脑损伤的一个有希望的标志。