Related Experiment Video
Updated: Aug 2, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Eight-year follow-up study of brain atrophy in patients with MS
E Fisher1, R A Rudick, J H Simon
1Whitaker Biomedical Imaging Laboratory, The Cleveland Clinic Foundation, OH 44195, USA. fisher@bme.ri.ccf.org
Objective:
To characterize whole-brain atrophy in relapsing-remitting MS (RRMS) patients over an 8-year period. The specific goals of this study were to determine if brain atrophy is related to subsequent disability status and to identify MRI correlates of atrophy progression.
Methods:
A follow-up study was conducted to reassess patients from a phase III trial of interferon beta-1a (IFNbeta-1a) 8 years after randomization. Clinical and MRI data from 172 patients followed over 2 years in the original trial were used as baseline data. Follow-up data were obtained on 160 patients, including 134 patients with follow-up MRI examinations. Brain atrophy was estimated by automated calculation of brain parenchymal fraction. The relation between atrophy during the original trial and disability status at follow-up was determined. Correlations were also determined between lesion measurements from the original trial and the brain parenchymal fraction at follow-up.
Results:
Brain atrophy was correlated with subsequent disability status. Atrophy rate during the original trial was the most significant MRI predictor of disability status at follow-up. Brain atrophy at follow-up was related to lesion volumes measured during the original trial.
Conclusions:
The relation between atrophy progression and subsequent neurologic disability status suggests that atrophy progression during RRMS is clinically relevant. Therefore, atrophy progression may be a useful marker for disease progression in clinical trials. The relation between lesions and subsequent atrophy indicates that brain atrophy may be related to focal tissue damage at earlier points in time, but important predisposing or other factors contributing to atrophy remain undefined.
Insights
Brain atrophy in relapsing-remitting MS (RRMS) is clinically relevant and predicts disability. Atrophy progression over 8 years is linked to lesion load, suggesting early tissue damage impacts long-term outcomes.
Area of Science:
- Neurology
- Radiology
- Neuroimmunology
Background:
- Relapsing-remitting multiple sclerosis (RRMS) is characterized by unpredictable neurological attacks.
- Brain atrophy is a key pathological feature in MS, but its long-term progression and relationship with disability are not fully understood.
- Understanding atrophy progression is crucial for monitoring disease course and evaluating treatment efficacy.
Purpose of the Study:
- To characterize whole-brain atrophy progression over an 8-year period in RRMS patients.
- To determine if brain atrophy is associated with subsequent disability status.
- To identify MRI correlates, specifically lesion load, associated with atrophy progression.
Main Methods:
- A longitudinal follow-up study reassessed 134 RRMS patients 8 years after a phase III trial of interferon beta-1a.
- Brain atrophy was quantified using automated calculation of brain parenchymal fraction.
- The relationship between baseline atrophy rate, lesion volume, and follow-up disability status was analyzed.
Main Results:
- Brain atrophy progression was significantly correlated with subsequent disability status in RRMS patients.
- The rate of atrophy during the initial trial period was the strongest MRI predictor of long-term disability.
- Brain atrophy at follow-up was associated with lesion volumes measured during the initial trial period.
Conclusions:
- Atrophy progression in RRMS is clinically relevant and a significant predictor of neurologic disability.
- Brain atrophy progression may serve as a valuable biomarker for disease progression in clinical trials.
- The link between lesions and atrophy suggests focal tissue damage contributes to brain atrophy, though other factors remain unidentified.
