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Progressive ventricular enlargement in patients with clinically isolated syndromes is associated with the early

C M Dalton1, P A Brex, R Jenkins

  • 1NMR Research Unit, Institute of Neurology, London, UK.

Journal of Neurology, Neurosurgery, and Psychiatry
|July 18, 2002
PubMed
Abstract

Insights

Brain atrophy and lesion load are linked to early multiple sclerosis (MS) development in patients with clinically isolated syndromes (CIS). MRI measures can help monitor early MS progression.

Area of Science:

  • Neurology
  • Radiology
  • Neuroimmunology

Background:

  • Clinically isolated syndromes (CIS) can precede multiple sclerosis (MS).
  • Brain lesion load on MRI predicts MS development in CIS patients.
  • Cerebral atrophy in early MS is not well understood regarding onset and relation to lesion load or clinical outcomes.

Purpose of the Study:

  • Investigate ventricular enlargement over one year in CIS patients.
  • Explore the relationship between ventricular enlargement, MRI lesion load, and clinical outcomes in early MS.

Main Methods:

  • A cohort of 55 CIS patients were recruited and imaged using MRI within three months of symptom onset and again after one year.
  • A semi-automated thresholding technique (MIDAS) was used to measure ventricular volume from MRI scans.
  • Patients were assessed for the development of clinically definite MS and fulfillment of McDonald MRI criteria.

Main Results:

  • 16 of 40 patients with abnormal baseline T2 scans developed clinical MS within one year.
  • Significant ventricular enlargement occurred in 27 of 55 patients meeting MS criteria, with a median increase of 0.3 cm³.
  • Significant ventricular volume increase was observed in 18 of 55 patients who developed clinical MS, with a median increase of 0.5 cm³.
  • Modest correlations were found between baseline lesion measures and subsequent ventricular enlargement.

Conclusions:

  • Both MRI-detected lesions and cerebral atrophy are associated with early relapse and diagnosis of clinical MS.
  • While MS lesions contribute to atrophy, other mechanisms may also drive its development.
  • MRI measures play a complementary role in monitoring MS progression, even in its earliest stages.

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