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Updated: Aug 9, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Magnetic resonance imaging measures of brain atrophy in multiple sclerosis
Valerie M Anderson1, Nick C Fox, David H Miller
1Department of Neuroinflammation, Institute of Neurology, University College of London, London, United Kingdom. vanderson@dementia.ion.ucl.ac.uk
Abstract:
Magnetic resonance imaging (MRI) has been widely used to diagnose and monitor multiple sclerosis (MS). Although MRI-visible lesions are a key feature of MS, they are thought to correlate poorly with clinical progression. Neurodegeneration is increasingly being recognized as an important factor in the pathogenesis of MS, and MRI measures of brain atrophy have been suggested as surrogate markers of neuroaxonal loss and disease progression. This pathology may be more relevant to the progression of disability than focal inflammation. A number of MRI-based methods have been developed for the measurement of global and regional brain atrophy. Natural-history studies of MS and clinically isolated syndromes suggestive of MS have observed atrophy in these subjects above that seen in controls, over periods ranging from three months to years. Brain atrophy has also been incorporated as an outcome measure in therapeutic trials of disease-modifying treatments. This paper considers neuroaxonal loss and the pathological basis of brain atrophy, methods developed to quantify brain atrophy, the findings of natural-history and therapeutic studies, the relationship of brain atrophy to disability and cognition, and the future research directions and clinical applications of brain atrophy measurements.
Insights
Brain atrophy, measured by MRI, is a key indicator of neurodegeneration and disability progression in multiple sclerosis (MS). This pathology is more relevant than focal inflammation for tracking MS progression.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Multiple sclerosis (MS) diagnosis and monitoring heavily rely on Magnetic Resonance Imaging (MRI).
- While MRI lesions are common in MS, their correlation with clinical progression is often poor.
- Neurodegeneration and subsequent brain atrophy are increasingly recognized as critical factors in MS pathogenesis and disability.
Purpose of the Study:
- To review the pathological basis of brain atrophy in MS.
- To discuss MRI-based methods for quantifying brain atrophy.
- To examine the relationship between brain atrophy, disability, and cognition in MS.
Main Methods:
- Review of natural-history studies and therapeutic trials in MS.
- Analysis of MRI-based methods for measuring global and regional brain atrophy.
- Correlation of brain atrophy measurements with clinical outcomes and cognitive function.
Main Results:
- Brain atrophy is observed in MS patients and those with clinically isolated syndromes, exceeding that in controls.
- MRI measures of brain atrophy serve as surrogate markers for neuroaxonal loss and disease progression.
- Brain atrophy is a significant predictor of disability and cognitive decline in MS.
Conclusions:
- Brain atrophy is a more relevant marker of MS progression and disability than focal MRI lesions.
- MRI-based quantification of brain atrophy is crucial for understanding MS pathogenesis and evaluating treatments.
- Future research should focus on refining atrophy measurement techniques and their clinical application in MS management.
