Assessing brain atrophy rates in a large population of untreated multiple sclerosis subtypes

Stefano, Nicola De; Giorgio, Antonio; Battaglini, Marco; Rovaris, Marco; Sormani, Maria Pia; Barkhof, Frederik; Korteweg, Tijmen; Enzinger, Christian; Fazekas, Franz; Calabrese, Massimiliano; Dinacci, Daria; Tedeschi, Gioacchino; Gass, Achim; Montalbán, Xavier; Rovira, Àlex; Thompson, Alan J.; Comi, Giancarlo; Miller, D. H.; Filippi, Massimo

doi:10.1212/wnl.0b013e3181e24136

Cited by 305 publications

(258 citation statements)

References 40 publications

(60 reference statements)

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“…This is an interesting result, because it suggests that, along with the predictive value of baseline lesion burden, the baseline brain volume is also a reliable predictor of future brainvolume changes and therefore of disease progression. 31 Lower baseline brain volumes found in this study can reflect more aggressive disease ongoing even before the first clinical manifestation. 32 The results from this study indicate that the association between accumulation of new/enlarging T2 lesions and development of whole-brain atrophy and enlargement of lateral ventricles was stronger than the association with the GM volume measures.…”

Section: Discussionmentioning

confidence: 60%

Longitudinal Mixed-Effect Model Analysis of the Association between Global and Tissue-Specific Brain Atrophy and Lesion Accumulation in Patients with Clinically Isolated Syndrome

Varosanec

Uher

Horáková³

et al. 2015

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 60%

Longitudinal Mixed-Effect Model Analysis of the Association between Global and Tissue-Specific Brain Atrophy and Lesion Accumulation in Patients with Clinically Isolated Syndrome

Varosanec

Uher

Horáková³

et al. 2015

AJNR Am J Neuroradiol

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“…Atrophy of the gray matter (GM) and white matter (WM) is frequently found in multiple sclerosis (MS), 1,2 and can be reliably measured with MRI. 3 Although already present in early stages, GM atrophy becomes much more dominant in the progressive phase of the disease.…”

Section: Discussionmentioning

confidence: 99%

Subcortical atrophy and cognition

Schoonheim

Popescu²,

Lopes³

et al. 2012

Neurology

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Objectives: Gray matter (GM) atrophy is common in multiple sclerosis (MS), as is cognitive dysfunction. Understanding the exact relationship between atrophy and cognition requires further investigation. The aim of this study was to investigate the relationship between subcortical GM atrophy and cognition in early relapsing onset MS.Methods: Structural MRI and neuropsychological evaluations were performed in 120 patients (80 women) and 50 controls (30 women), part of an early inception cohort, 6 years postdiagnosis. Deep GM volumes were segmented automatically. Cognition was assessed in 7 domains.Stepwise linear regression was used to predict average cognition in the patient group.Results: Most deep GM volumes were reduced in patients, with larger effects on average in men (Ϫ11%) than in women (Ϫ6.3%). Only the bilateral hippocampus, amygdala, and right nucleus accumbens in men, and right hippocampus and nucleus accumbens, bilateral amygdala, and putamen in women, showed no atrophy compared to controls. All cognitive domains except visuospatial memory were affected in men; none were significantly affected in women. In the MS group, average cognition was best predicted by thalamic volume, sex, and education (adjusted R 2 ϭ 0.31), while lesion volume was not a significant predictor in the model. Conclusions:Six years postdiagnosis, almost all subcortical structures were affected by MS, especially in men. Cognition was most severely affected in male patients. Thalamic volume, sex, and education best predicted average cognition. These results underline the relevance of specific subcortical structures to cognition, as well as the relevance of (sex-specific) atrophy in MS. Neurology ® 2012;79:1754-1761 GLOSSARY BRB-N ϭ Brief Repeatable Battery for Neurological disease; DGM ϭ deep gray matter; DMT ϭ disease-modifying therapy; EDSS ϭ Expanded Disability Status Scale; GLM ϭ general linear model; GM ϭ gray matter; MS ϭ multiple sclerosis; NBV ϭ normalized whole brain volume; NCGMV ϭ normalized cortical gray matter volume; NDGMV ϭ normalized deep gray matter volume; NGMV ϭ normalized total gray matter volume; NWMV ϭ normalized total white matter volume; RRMS ϭ relapsingremitting multiple sclerosis; WM ϭ white matter.Atrophy of the gray matter (GM) and white matter (WM) is frequently found in multiple sclerosis (MS), 1,2 and can be reliably measured with MRI.3 Although already present in early stages, GM atrophy becomes much more dominant in the progressive phase of the disease. 4 As the clinical relevance and the specific histopathologic substrate of GM atrophy in MS is not well known, it is the subject of many recent studies. 5,6 While the relationship between brain atrophy and clinical measures has been investigated extensively in the past, 7 how atrophy relates to cognition is only recently becoming clearer. -11As cognitive dysfunction is common and present in all stages of the disease, 12-15 exploring the relationship between atrophy and cognition could provide valuable new information.As most studies that focus...

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“…32 Over the past few years, several studies have used MRI derived methods to assess brain volume changes, revealing that atrophy can be present even in the early stages of MS, and that it advances over the disease course (Figure 2). 33,34 Generally speaking, brain volume changes can be an important measure of tissue damage in patients with MS. 32 Indeed, baseline atrophy and high rates of subsequent volume loss are associated with cognitive impairment, fatigue and disability progression over the long term. 32,[35][36][37][38][39][40][41] In a complex disease such as MS, brain volume loss results from the sum of and interactions between various destructive pathological processes, 42 including irrever sible demyelination, and axonal and/or neuronal loss.…”

Section: Focal Lesionsmentioning

confidence: 99%

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—establishing disease prognosis and monitoring patients

2015

Nat Rev Neurol

413

147

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Assessing brain atrophy rates in a large population of untreated multiple sclerosis subtypes

Abstract: This first large study in untreated patients with multiple sclerosis (MS) with different disease subtypes shows that brain atrophy proceeds relentlessly throughout the course of MS, with a rate that seems largely independent of the MS subtype, when adjusting for baseline brain volume.

Cited by 305 publications

References 40 publications

Longitudinal Mixed-Effect Model Analysis of the Association between Global and Tissue-Specific Brain Atrophy and Lesion Accumulation in Patients with Clinically Isolated Syndrome

Longitudinal Mixed-Effect Model Analysis of the Association between Global and Tissue-Specific Brain Atrophy and Lesion Accumulation in Patients with Clinically Isolated Syndrome

Subcortical atrophy and cognition

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—establishing disease prognosis and monitoring patients

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