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From enhancing lesions to brain atrophy in relapsing MS
1Department of Radiology, University of Colorado Health Sciences Center, Denver 80262, USA. jsimon@ewok.uhcolorado.edu
Journal of Neuroimmunology
|July 30, 1999
Summary
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.