Key Clinical Summary

• African American patients with multiple sclerosis (MS) demonstrated significantly greater neurodegeneration and worse cognitive and motor outcomes than White patients despite shorter disease duration.
• Brain imaging showed lower gray matter volume, thinner cortical thickness, and greater evidence of accelerated brain aging in African American patients.
• Investigators said the findings support the need for race-specific approaches to MS management and monitoring.

New research presented at the 2026 Annual Meeting of the Consortium of Multiple Sclerosis Centers found substantial racial disparities in neurodegeneration, cognition, and motor performance among patients with MS, with African American patients showing more severe disease-related changes than White patients despite having a shorter duration of illness.

Racial Differences in Brain Aging and Functional Decline 

The cross-sectional study included 121 patients with MS, including 59 African American participants and 62 White participants. Investigators used advanced neuroimaging, metabolic, cognitive, and functional assessments to compare disease burden between groups.

African American patients demonstrated significantly greater evidence of neurodegeneration. Median gray matter volume was lower among African American patients than White patients (583.9 mL vs 636.1 mL; P < .001), and global cortical thickness was also significantly reduced.

Importantly, these differences were observed despite African American patients having a significantly shorter median disease duration, at 5.5 years compared with 8.0 years in White patients.

Functional and cognitive testing similarly showed poorer outcomes among African American patients. On the 9-Hole Peg Test, dominant hand performance averaged 26.3 seconds compared with 20.6 seconds in White patients, while nondominant hand performance averaged 27.7 seconds vs 22.6 seconds.

Cognitive assessments also revealed significant disparities. Symbol Digit Modalities Test scores were substantially lower in African American patients (37.0 vs 59.0; P < .001), as were Paced Auditory Serial Addition Test scores. Quality-of-life outcomes were also worse among African American patients with MS.

Metabolic and microstructural imaging markers further supported a more severe disease burden. Total N-acetylaspartate to total creatine ratio was lower in African American patients, while fractional anisotropy in normal-appearing white matter was significantly worse.

Multivariate linear regression analysis identified race as an independent predictor of accelerated brain aging, with an estimated increase of 6.019 years after adjusting for sex, body mass index, disease duration, and disease-modifying therapy use.

Implications for Earlier Monitoring and Personalized MS Care

For clinicians and managed care stakeholders, the findings underscore growing evidence that MS disease burden may differ substantially across racial groups, even when disease duration is shorter.

The observed disparities in cognition, motor function, neurodegeneration, and quality of life suggest that African American patients may require earlier monitoring, more aggressive intervention strategies, and individualized treatment approaches.

The results also reinforce ongoing concerns regarding health care disparities, delayed diagnosis, treatment access, and underrepresentation of minority populations in MS research.

Addressing Racial Gaps in MS Care Remains a Critical Priority

The study adds to mounting evidence that African American patients with MS may experience more aggressive disease progression and greater neurologic impairment than White patients. Researchers said targeted management strategies and improved understanding of racial disparities in MS remain critical priorities.

References

Nourelden AZ, Bao F, Patel N, et al. Racial disparities in multiple sclerosis: differences in neurodegeneration, metabolism, cognition, and motor functions between African American and White individuals. Presented at: Consortium of Multiple Sclerosis Centers Annual Meeting; May 27-29, 2026; Charlotte, NC.