Related Experiment Videos
A longitudinal study of brain atrophy in relapsing multiple sclerosis. The Multiple Sclerosis Collaborative Research
J H Simon1, L D Jacobs, M K Campion
1Department of Radiology-MRI, University of Colorado Health Sciences Center, Denver 80262, USA.
Objective:
To determine if progressive brain atrophy could be detected over 1- and 2-year intervals in relapsing MS, based on annual MR studies from the Multiple Sclerosis Collaborative Research Group (MSCRG) trial of interferon beta-1a (Avonex).
Methods:
All subjects had mild to moderate disability, with baseline expanded disability status scores ranging from 1.0 to 3.5, and at least two relapses in the 3 years before study entry. Atrophy measures included third and lateral ventricle width, brain width, and corpus callosum area.
Results:
Significant increases were detected in third ventricle width at year 2 and lateral ventricle width at 1 and 2 years. Significant decreases in corpus callosum area and brain width were also observed at 1 and 2 years. Multiple regression analyses suggested that the number of gadolinium-enhancing lesions at baseline was the single significant contributor to change in third ventricle width. Atrophy over 1 and 2 years as indicated by enlargement of the third and lateral ventricle and shrinkage of the corpus callosum was greater for patients entering the trial with enhancing lesions. Greater disability increments over 1 and 2 years were associated with more severe third ventricle enlargement.
Conclusion:
In patients with relapsing MS and only mild to moderate disability, significant cerebral atrophy is already developing that can be measured over periods of only 1 to 2 years. The course of cerebral atrophy in MS appears to be influenced by prior inflammatory disease activity as indicated by the presence of enhancing lesions. Brain atrophy measures are important markers of MS disease progression because they likely reflect destructive and irreversible pathologic processes.
Insights
Progressive brain atrophy is detectable in relapsing multiple sclerosis (MS) patients within 1-2 years. Inflammatory activity, indicated by enhancing lesions, influences atrophy progression, highlighting its role in irreversible MS damage.
Area of Science:
- Neurology
- Neuroimaging
- Multiple Sclerosis Research
Background:
- Relapsing-remitting multiple sclerosis (MS) is characterized by inflammatory attacks and neurodegeneration.
- Measuring brain atrophy is crucial for understanding MS disease progression and treatment efficacy.
Purpose of the Study:
- To assess the detectability of progressive brain atrophy in relapsing MS over 1- and 2-year intervals.
- To correlate baseline inflammatory activity with the rate of brain atrophy in MS patients.
Main Methods:
- Utilized annual MRI studies from the Multiple Sclerosis Collaborative Research Group (MSCRG) trial.
- Measured atrophy using ventricle width and brain/corpus callosum dimensions.
- Included patients with mild to moderate disability and recent relapses.
Main Results:
- Significant increases in third and lateral ventricle width observed at 1 and 2 years.
- Significant decreases in corpus callosum area and brain width noted over the same period.
- Baseline enhancing lesions predicted greater atrophy and were linked to increased disability.
Conclusions:
- Cerebral atrophy is measurable in relapsing MS within 1-2 years, even with mild disability.
- Inflammatory activity, evidenced by enhancing lesions, significantly influences MS brain atrophy.
- Brain atrophy measurements serve as critical indicators of irreversible pathological processes in MS progression.