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Updated: Jun 24, 2026
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Quantification and clinical relevance of brain atrophy in multiple sclerosis: a review
Blandine Grassiot1, Béatrice Desgranges, Francis Eustache
1Département de Neurologie, CHU Côte de Nacre, 14000 Caen, France.
Abstract:
Multiple sclerosis is known to be an inflammatory demyelinating disease characterized mainly by multifocal areas of white matter lesions. Recently, cortical lesions and brain atrophy have emerged as new pathological markers of disease progression. Brain tissue loss can now be easily and reproducibly detected and quantified by MRI, which has led to an increasing amount of research correlating brain tissue loss with other MRI markers, such as white matter lesions, and to clinical disabilities (motor or cognitive), in order to assess its clinical relevance. In this review, we summarize the different MRI-based methods used to quantify whole and regional brain atrophy, and discuss the relevance of brain atrophy in MS through its relationship with characteristic brain lesions, disability and cognition. Lastly, we emphasize the role of brain atrophy in different phenotypes of MS. According to this review of the current literature, the grey matter (GM) atrophy is now well-established in MS and has been found to be strongly associated with clinical and cognitive deterioration. This GM volume loss is characterized by a focal atrophy in the deep grey nuclei but also by diffuse cortical atrophy. Phenotypic variation can be associated with different degrees and regional location of brain atrophy but more investigations are necessary to specify the discrepancies against brain atrophy between the different forms of the disease.
Insights
Grey matter atrophy is a key indicator of multiple sclerosis (MS) progression, strongly linked to clinical and cognitive decline. This review details MRI methods for quantifying atrophy and its relevance in MS phenotypes.
Area of Science:
- Neurology
- Radiology
- Neuroscience
Background:
- Multiple sclerosis (MS) is an inflammatory demyelinating disease.
- White matter lesions are traditional markers, but cortical lesions and brain atrophy are emerging as critical indicators of disease progression.
- Magnetic Resonance Imaging (MRI) enables reproducible quantification of brain tissue loss.
Purpose of the Study:
- To review MRI-based methods for quantifying whole and regional brain atrophy in MS.
- To discuss the clinical relevance of brain atrophy by examining its relationship with white matter lesions, motor, and cognitive disabilities.
- To emphasize the role of brain atrophy across different MS phenotypes.
Main Methods:
- Review of current literature on MRI-based quantification of brain atrophy.
- Correlation analysis between brain atrophy, white matter lesions, and clinical/cognitive disability.
- Examination of brain atrophy patterns in various MS phenotypes.
Main Results:
- Grey matter (GM) atrophy is well-established in MS and significantly associated with clinical and cognitive deterioration.
- GM volume loss manifests as focal atrophy in deep grey nuclei and diffuse cortical atrophy.
- Phenotypic variations in MS correlate with different degrees and regional locations of brain atrophy.
Conclusions:
- Brain atrophy, particularly grey matter atrophy, is a crucial pathological marker in MS progression.
- MRI quantification of brain atrophy is vital for understanding its association with disability and cognition.
- Further research is needed to elucidate the specific discrepancies in brain atrophy across different MS forms.
