Whole-brain atrophy: ready for implementation into clinical decision-making in multiple sclerosis?

Area of Science:

• Neurology
• Radiology
• Biomedical Engineering

Background:

• Whole-brain atrophy is a clinically significant and early-presenting feature of multiple sclerosis (MS).
• Magnetic Resonance Imaging (MRI) allows for reproducible measurement of whole-brain atrophy.
• Current disease-modifying therapies show potential in slowing whole-brain atrophy rates at a group level.

Purpose of the Study:

• To review the significance of whole-brain atrophy in multiple sclerosis (MS).
• To outline the necessary steps for integrating whole-brain volume measurements into routine clinical practice for MS management.

Main Methods:

• Review of current literature on whole-brain atrophy in MS.
• Analysis of the clinical relevance and measurability of whole-brain atrophy using MRI.
• Identification of prerequisites for clinical implementation of whole-brain volume metrics.

Main Results:

• Whole-brain atrophy is a relevant, early, and reproducible MRI-detectable marker in MS.
• Approved MS therapies can reduce whole-brain atrophy rates in study groups.
• Clinicians may consider utilizing whole-brain volume measurements for patient care decisions.

Conclusions:

• Standardized MRI protocols for MS are essential for consistent whole-brain volume measurement.
• A gold-standard postprocessing software is required for reliable whole-brain atrophy quantification.
• Development of statistical methods is needed to translate group-level findings to individual patient metrics.
• As neurodegeneration research advances in MS, MRI metrics will be crucial for monitoring disease progression and treatment efficacy.