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Updated: Feb 18, 2026
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Pathological cut-offs of global and regional brain volume loss in multiple sclerosis
Tomas Uher1, Manuela Vaneckova2, Jan Krasensky2
1Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
Background:
Volumetric MRI surrogate markers of disease progression are lacking.
Objective:
To establish cut-off values of brain volume loss able to discriminate between healthy controls and MS patients.
Methods:
In total, 386 patients after first demyelinating event suggestive of MS (CIS), 964 relapsing-remitting MS (RRMS) patients, 63 secondary-progressive MS (SPMS) patients and 58 healthy controls were included in this longitudinal study. A total of 11,438 MRI scans performed on the same MRI scanner with the same protocol were analysed. Annualised percentage changes of whole brain, grey matter, thalamus and corpus callosum volumes were estimated. We investigated cut-offs able to discriminate between healthy controls and MS patients.
Results:
At a predefined specificity of 90%, the annualised percentage change cut-off of corpus callosum volume (-0.57%) was able to distinguish between healthy controls and patients with the highest sensitivity (51% in CIS, 48% in RRMS and 42% in SPMS patients). Lower sensitivities (22%-49%) were found for cut-offs of whole brain, grey matter and thalamic volume loss. Among CIS and RRMS patients, cut-offs were associated with greater accumulation of disability.
Conclusion:
We identified cut-offs of annualised global and regional brain volume loss rates able to discriminate between healthy controls and MS patients.
Insights
Researchers identified specific rates of brain volume loss using MRI to differentiate between healthy individuals and multiple sclerosis (MS) patients. These cut-offs, particularly for the corpus callosum, show promise in tracking MS progression.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Volumetric magnetic resonance imaging (MRI) lacks established surrogate markers for disease progression in multiple sclerosis (MS).
- Accurate monitoring of MS progression is crucial for effective treatment strategies.
Purpose of the Study:
- To establish cut-off values for brain volume loss detectable via volumetric MRI.
- To determine if these cut-offs can effectively discriminate between healthy controls and MS patients across different disease subtypes.
Main Methods:
- Longitudinal analysis of 11,438 MRI scans from 386 clinically isolated syndrome (CIS), 964 relapsing-remitting MS (RRMS), 63 secondary-progressive MS (SPMS) patients, and 58 healthy controls.
- Estimation of annualised percentage changes in whole brain, grey matter, thalamus, and corpus callosum volumes.
- Investigation of cut-off values for discriminating between healthy controls and MS patients at 90% specificity.
Main Results:
- An annualised corpus callosum volume loss of -0.57% demonstrated the highest sensitivity (42-51%) in distinguishing MS patients from controls.
- Lower sensitivities (22-49%) were observed for whole brain, grey matter, and thalamic volume loss cut-offs.
- Identified cut-offs correlated with increased disability accumulation in CIS and RRMS patients.
Conclusions:
- Established cut-offs for annualised global and regional brain volume loss rates can discriminate between healthy individuals and MS patients.
- Corpus callosum volume loss rate is a sensitive MRI marker for differentiating MS patients.
- These findings provide valuable volumetric MRI surrogate markers for MS progression.
