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Short-term ventricular volume changes on serial MRI in multiple sclerosis
I T Redmond1, S Barbosa, L D Blumhardt
1Division of Clinical Neurology, University of Nottingham, UK.
Abstract:
Axonal loss is likely to be an important component of atrophy and the pathological substrate for the fixed disability of MS. To estimate the rate of central white matter reduction we investigated ventricular volume change and disease activity on monthly MRI in 19 patients over 6 months. At baseline, ventricular volumes were largest in primary progressive MS and smallest in relapsing-remitting MS. Over the study period ventricular volumes increased overall by 0.2% (F= 2.75, P = 0.02), but the percentage changes in relapsing-remitting MS were much larger (median increase 14.9%). Lesion volumes were also highest at baseline in relapsing-remitting MS, but serial changes in ventricular volumes were not correlated with serial changes in lesions. This study shows that ventricular enlargement in MS may occur over short epochs, particularly in relapsing-remitting cases. However, the loss of central white matter volume observed in any brief period may be related to inflammatory activity that occurred in a preceding or earlier epoch, a delayed post-inflammatory degenerative process, or most likely, a combination of both.
Insights
Multiple Sclerosis (MS) patients experience central white matter reduction, particularly in relapsing-remitting MS. Ventricular enlargement over six months suggests rapid atrophy, potentially linked to inflammation.
Area of Science:
- Neuroscience
- Radiology
- Immunology
Background:
- Axonal loss is a key factor in Multiple Sclerosis (MS) atrophy and fixed disability.
- Estimating the rate of central white matter reduction is crucial for understanding MS progression.
Purpose of the Study:
- To investigate the rate of central white matter reduction by analyzing ventricular volume changes.
- To correlate ventricular volume changes with disease activity on MRI over a 6-month period in MS patients.
Main Methods:
- Monthly MRI scans were performed on 19 patients over 6 months.
- Ventricular volumes and lesion volumes were measured at baseline and serially.
- Statistical analysis was used to assess changes and correlations.
Main Results:
- Overall ventricular volume increased by 0.2% over the study period (P=0.02).
- Relapsing-remitting MS showed significantly larger median ventricular volume increases (14.9%).
- Ventricular volume changes did not correlate with serial changes in lesion volumes.
Conclusions:
- Ventricular enlargement, indicating white matter loss, can occur rapidly in MS, especially in relapsing-remitting MS.
- This rapid atrophy may be associated with preceding or ongoing inflammatory activity.
- A combination of inflammatory and degenerative processes likely contributes to white matter loss in MS.