Validation of linear cerebral atrophy markers in multiple sclerosis

Area of Science:

• Neurology
• Radiology
• Neuroimaging

Background:

• Cerebral atrophy is a key feature of multiple sclerosis (MS).
• Linear measures of cerebral ventricular enlargement may serve as surrogate markers for atrophy.
• Monitoring atrophy progression is crucial for MS management.

Purpose of the Study:

• To evaluate the utility of linear atrophy markers derived from routine MRI scans in assessing cerebral atrophy in MS patients.
• To determine if inter-caudate distance (ICD) and third ventricle width (TVW) can differentiate MS cases from controls.
• To validate these linear measures against brain parenchymal volume for monitoring MS progression.

Main Methods:

• A population survey measured ICD, TVW, and frontal horn width (FHW) in 171 Tasmanian MS patients and 91 controls using routine MRI scans.
• A validation cohort of 35 MS clinic patients was recruited, with 14 re-assessed after 4 years.
• Inter-caudate ratio (ICR) and third ventricular ratio (TVR) were correlated with brain parenchymal volume cross-sectionally and longitudinally.

Main Results:

• TVW (OR 2.0, p=0.001) and ICD (OR 16.1, p<0.001) significantly differentiated MS cases from controls.
• Cross-sectionally, ICR (R=-0.453, p<0.01) and TVR (R=-0.653, p<0.01) correlated with brain parenchymal volume.
• Longitudinally, brain parenchymal volume loss inversely correlated with increased ICD (R=-0.77, p<0.01) and TVW (R=-0.71, p<0.01).

Conclusions:

• Linear measures, particularly inter-caudate distance (ICD), are valid and reliable indicators of cerebral atrophy in multiple sclerosis.
• These measurements, obtainable from routine MRI scans, can be effectively used for monitoring MS progression.
• The findings support the integration of simple linear atrophy markers into routine clinical practice for MS patient management.