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Enhancing magnetic resonance imaging lesions and cerebral atrophy in patients with relapsing multiple sclerosis
T P Leist1, M I Gobbini, J A Frank
1Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 9000 Rockville Pike, Bldg 10, Room 5B16, Bethesda, MD 20892, USA.
Objective:
To examine the relation between the frequency of enhancing magnetic resonance imaging lesions and their characteristics of enhancement and atrophy in patients with early relapsing multiple sclerosis.
Design:
Analysis of number of enhancing lesions, ventricular volumes and diameters, and lesion characteristics on monthly magnetic resonance imaging scans during natural history follow-up.
Setting:
A clinical research institution.
Patients:
Sixteen patients with confirmed early relapsing multiple sclerosis.
Main Outcome Measure:
Cerebral atrophy as measured by ventricular enlargement.
Results:
Numbers of enhancing lesions correlated well with an increase of ventricular size. This correlation was strongest for patients with a high proportion of concentric ring-enhancing lesions with central contrast pallor.
Conclusions:
Inflammatory events, especially those within lesions with associated blood-brain barrier breakdown, affect the ensuing loss of brain parenchyma. Patients with a high proportion of lesions with central contrast pallor, which is likely associated with more extensive tissue damage, have a higher rate of atrophic changes.