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From enhancing lesions to brain atrophy in relapsing MS

J H Simon1

  • 1Department of Radiology, University of Colorado Health Sciences Center, Denver 80262, USA. jsimon@ewok.uhcolorado.edu

Journal of Neuroimmunology
|July 30, 1999
PubMed

Insights

Multiple Sclerosis (MS) lesions evolve from inflammatory to chronic stages. Early inflammatory MS lesions predict later brain atrophy, suggesting a link to axonal injury.

Area of Science:

  • Neuroimaging
  • Neurology
  • Pathophysiology

Background:

  • Multiple Sclerosis (MS) lesions undergo a natural progression observed via Magnetic Resonance (MR) imaging.
  • Lesions evolve from acute, enhancing inflammatory stages to chronic, T2 hyperintense lesions, serving as non-specific markers of past events.

Purpose of the Study:

  • To investigate the relationship between early MS lesion characteristics and the development of cerebral atrophy.
  • To explore whether prior enhancing lesions predict subsequent volume loss in the brain.

Main Methods:

  • Longitudinal evaluation of patients with MS using MR imaging.
  • Analysis of lesion evolution from acute enhancing to chronic T2 hyperintense stages.
  • Assessment of cerebral atrophy, specifically volume loss around the third ventricle.

Main Results:

  • Accumulation of non-specific chronic T2 lesions occurs alongside significant cerebral atrophy, even in patients with mild disability.
  • The presence of prior, temporally and anatomically distant enhancing lesions predicts cerebral atrophy.
  • Volume loss around the third ventricle is particularly associated with prior enhancing lesions.

Conclusions:

  • Early inflammatory events in MS, represented by enhancing lesions, initiate processes leading to cerebral atrophy.
  • Axonal injury may be an early mechanism contributing to the development of cerebral atrophy in MS.
  • Understanding this progression may offer insights into early therapeutic interventions for MS.

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