Ventricular enlargement in MS: one-year change at various stages of disease

Area of Science:

• Neuroimaging
• Neurology
• Medical Research

Background:

• Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
• Cerebral atrophy is a known consequence of MS, but its progression across different disease stages requires further investigation.
• Ventricular enlargement (VE) is a potential indicator of brain atrophy.

Purpose of the Study:

• To quantify ventricular enlargement (VE) over one year in patients with multiple sclerosis (MS) at various disease stages.
• To compare the rate of VE across different MS phenotypes: clinically isolated syndromes (CIS), early relapse-onset MS, relapsing-remitting MS (RRMS), and secondary progressive MS (SPMS).

Main Methods:

• A semi-automated technique was used to measure VE on MRI scans.
• The study included patients with CIS (n=26), early MS (n=30), established RRMS (n=41), and SPMS (n=23).
• Changes in T2 and T1 hypointense lesion volumes were also assessed.

Main Results:

• Ventricular enlargement was observed in early MS (median increase 0.3 mL), RRMS (median increase 0.5 mL), and SPMS (median increase 1.1 mL) after one year.
• SPMS group showed significantly more VE compared to other groups, even after adjusting for age (p = 0.005).
• No significant VE was detected in the CIS group (median decrease -0.001 mL).

Conclusions:

• Ventricular enlargement is a sensitive marker of progressive cerebral atrophy in multiple sclerosis.
• VE is evident across all stages of MS, with a more pronounced progression in SPMS compared to RRMS.
• These findings highlight VE as a valuable metric for monitoring disease progression in MS.