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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Relationship between inflammatory lesions and cerebral atrophy in multiple sclerosis
N D Richert1, T Howard, J A Frank
1National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD 20892-1400, USA. richertn@helix.nih.gov
Neurology
|March 1, 2006
Summary
Cerebral atrophy in relapsing-remitting multiple sclerosis (RRMS) patients closely followed the accumulation of contrast-enhancing lesions (CEL). Effective treatments reducing CEL also slowed brain atrophy, indicating a link between inflammation and tissue loss.
Area of Science:
- Neuroimaging
- Neurology
- Inflammation Research
Background:
- Relapsing-remitting multiple sclerosis (RRMS) is characterized by inflammatory attacks and neurodegeneration.
- Understanding the relationship between active inflammation and brain atrophy is crucial for disease management.
Purpose of the Study:
- To investigate the temporal relationship between active inflammation (contrast-enhancing lesions) and cerebral atrophy in RRMS patients.
- To assess if treatments reducing inflammatory lesions impact the rate of brain volume loss.
Main Methods:
- Longitudinal study of 19 RRMS patients over an average of 4 years.
- Serial monthly MRI scans to quantify contrast-enhancing lesions (CEL).
- Monthly brain fractional volume (BFV) measurements to assess cerebral atrophy (PBVC).
Main Results:
- Cerebral atrophy (PBVC) paralleled the accumulation of contrast-enhancing lesions (CEL).
- A strong correlation (R2 = 0.47 to 0.81) was observed between cumulative CEL and PBVC.
- Immunomodulatory treatments that reduced CEL also slowed the rate of atrophy.
Conclusions:
- Active inflammation (CEL) is closely linked to the development of cerebral atrophy in RRMS.
- Patients with persistent CEL despite therapy may be at higher risk for increased brain atrophy.
- Monitoring CEL may help identify patients at risk for significant neurodegeneration.
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