In this cross-sectional study, voxel-based morphometry and voxel-based quantification analyses of longitudinal relaxation rate (R1) and quantitative susceptibility (QSM) maps, reflecting myelin and iron, respectively, were conducted on 117 patients with MS (pwMS) and 53 healthy controls. Between-group differences and correlations with clinical variables (global disability, cognitive and motor performance) were assessed. We found widespread atrophy and R1 decrease in pwMS, with smaller clusters of reduced susceptibility in the thalami and cerebral WM. While subcortical atrophy and WM iron depletion contributed to global and motor disability, deep GM atrophy and R1 decrease in lesional areas correlated with cognitive performance.
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