{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T09:06:24Z","timestamp":1784624784567,"version":"3.55.0"},"reference-count":116,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University. \u201cDun\u0103rea de Jos\u201d, Galati, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background: Multiple sclerosis (MS) is a neurodegenerative and chronic inflammatory disease, often associated with psychiatric comorbidities, particularly depression and anxiety, which play a major role in disability, cognitive dysfunction, and quality of life. Growing evidence suggests that affective symptoms in MS are not only related to psychosocial burden but also to structural and functional abnormalities in the brain that can be identified using magnetic resonance imaging (MRI). Methods: A systematic database search was performed to identify studies for a structured narrative review. Original articles that examined MRI correlates of depression and anxiety in adult MS patients were included. Structural MRI, diffusion imaging, and functional MRI studies evaluating lesion distribution, cortical and subcortical atrophy, white matter microstructure, and network connectivity were analyzed alongside psychometric instruments used to assess affective symptoms. Results: Depression in MS was consistently associated with fronto-limbic and subcortical abnormalities including cortical thinning, hippocampal and thalamic atrophy, white matter disconnection and altered connectivity within the default mode, salience and executive control networks. Diffusion MRI studies have shown microstructural damage in associative white matter tracts, and functional MRI studies have supported a model of network-level dysfunction. In contrast, anxiety had less robust and reproducible associations with conventional MRI findings, indicating a more complex interaction between inflammatory, neurobiological and psychosocial mechanisms. Conclusions: Multimodal MRI approaches may increase our knowledge of the neurobiological substrates of depression and anxiety in MS and may contribute to more personalized diagnostic and therapeutic strategies.<\/jats:p>","DOI":"10.3390\/diseases14070262","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T08:14:27Z","timestamp":1784621667000},"page":"262","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["MRI Correlates of Depression and Anxiety in Multiple Sclerosis"],"prefix":"10.3390","volume":"14","author":[{"given":"Loredana Sabina","family":"Pascu","sequence":"first","affiliation":[{"name":"Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona Dana","family":"Mitincu-Caramfil","sequence":"additional","affiliation":[{"name":"Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3437-570X","authenticated-orcid":false,"given":"Andrei Vlad","family":"Bradeanu","sequence":"additional","affiliation":[{"name":"Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6291-1008","authenticated-orcid":false,"given":"Ancu\u021ba","family":"Iacob","sequence":"additional","affiliation":[{"name":"Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2807-7742","authenticated-orcid":false,"given":"Mihaela","family":"Lungu","sequence":"additional","affiliation":[{"name":"Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ileana","family":"Marinescu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard Polea","family":"Drima","sequence":"additional","affiliation":[{"name":"Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.4172\/1745-7580.10000125","article-title":"Elucidating the Molecular Basis of Multiple Sclerosis and Understanding the Disease Pathophysiology","volume":"12","author":"Eiman","year":"2016","journal-title":"Immunome Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.pathog.2016.04.001","article-title":"Multiple sclerosis is prominent in the Gulf states: Review","volume":"3","author":"Mohammed","year":"2016","journal-title":"Pathogenesis"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1126\/science.abj8222","article-title":"Longitudinal analysis reveals high prevalence of Epstein-Barr virus associated with multiple sclerosis","volume":"375","author":"Bjornevik","year":"2022","journal-title":"Science"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.clinimag.2021.05.025","article-title":"Diagnostic approach in multiple sclerosis with MRI: An update","volume":"78","author":"Weidauer","year":"2021","journal-title":"Clin. 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