Brain atrophy and lesion load in a large population of patients with multiple sclerosis
G Tedeschi1, L Lavorgna, P Russo
1Department of Neurological Sciences, Second University of Naples, Piazza Miraglia 2, 80138 Naples, Italy. gioacchino.tedeschi@unina2.it
Objective:
To measure white matter (WM) and gray matter (GM) atrophy and lesion load in a large population of patients with multiple sclerosis (MS) using a fully automated, operator-independent, multiparametric segmentation method.
Methods:
The study population consisted of 597 patients with MS and 104 control subjects. The MRI parameters were abnormal WM fraction (AWM-f), global WM-f (gWM-f), and GM fraction (GM-f).
Results:
Significant differences between patients with MS and control subjects included higher AWM-f and reduced gWM-f and GM-f. MRI data showed significant differences between patients with relapsing-remitting and secondary progressive forms of MS. Significant correlations between MRI parameters and between MRI and clinical data were found.
Conclusions:
Patients with multiple sclerosis have significant atrophy of both white matter (WM) and gray matter (GM); secondary progressive patients have significantly more atrophy of both WM and GM than do relapsing-remitting patients and a significantly higher lesion load (abnormal WM fraction); lesion load is related to both WM and even more to GM atrophy; lesion load and WM and GM atrophy are significantly related to Expanded Disability Status Scale score and age at onset (suggesting that the younger the age at disease onset, the worse the lesion load and brain atrophy); and GM atrophy is the most significant MRI variable in determining the final disability.
Insights
Multiple sclerosis patients show significant white matter (WM) and gray matter (GM) atrophy. Secondary progressive MS involves greater atrophy and lesion load, with GM atrophy most impacting disability.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Multiple sclerosis (MS) is a chronic demyelinating disease affecting the central nervous system.
- Brain atrophy and lesion load are key indicators of MS progression and disability.
Purpose of the Study:
- To quantify white matter (WM) and gray matter (GM) atrophy and lesion load in a large MS cohort.
- To utilize a fully automated, operator-independent, multiparametric segmentation method for MRI analysis.
Main Methods:
- Analysis of MRI parameters including abnormal WM fraction (AWM-f), global WM-f (gWM-f), and GM fraction (GM-f).
- Study included 597 MS patients and 104 controls.
Main Results:
- MS patients exhibited higher AWM-f and reduced gWM-f and GM-f compared to controls.
- Significant differences in MRI parameters were observed between relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS) patients.
- Correlations found between MRI parameters and between MRI and clinical data.
Conclusions:
- MS patients demonstrate significant WM and GM atrophy.
- SPMS patients show greater WM/GM atrophy and lesion load than RRMS patients.
- GM atrophy is the strongest MRI predictor of disability in MS.
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