This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Locatelli, L. Articles by Zorzon, M. Search for Related Content PubMed PubMed Citation Articles by Locatelli, L. Articles by Zorzon, M. Social Bookmarking                         What's this?

Frontal parenchymal atrophy measures in multiple sclerosis

Department of Clinical Medicine and Neurology, University of Trieste, Trieste, Italy

Robert Zivadinov

Department of Clinical Medicine and Neurology, University of Trieste, Trieste, Italy, Buffalo Neuroimaging Analysis Center, The Jacobs Neurological Institute, Department of Neurology, University at Buffalo, State University of New York, Buffalo, NY, USA, rzivadinov{at}thejni.org

Attilio Grop

Department of Clinical Medicine and Neurology, University of Trieste, Trieste, Italy

Marino Zorzon

Department of Clinical Medicine and Neurology, University of Trieste, Trieste, Italy

The aim of this study was to establish whether, in a cross-sectional study, the normalized measures of whole and regional brain atrophy correlate better with tests assessing the cognitive function than the absolute brain atrophy measures. The neuropsychological performances and disability have been assessed in 39 patients with relapsing-remitting multiple sclerosis (MS). T1- and T2-lesion load (LL) of total brain and frontal lobes (FLs) were measured using a reproducible semiautomated technique. The whole brain volume and the regional brain parenchymal volume (RBPV) of FLs were obtained using a computerized interactive program, which incorporates semiautomated and automated segmentation processes. Normalized measures of brain atrophy, i.e., brain parenchymal fraction (BPF) and regional brain parenchymal fraction (RBPF) of FLs, were calculated. The scan-rescan, inter- and intrarater coefficient of variation (COV) and intraclass correlation coefficient (ICC) have been estimated. The RBPF of FLs showed an acceptable level of reproducibility which ranged from 1.7% for intrarater variability to 3.2% for scan-rescan variability. The mean ICC was 0.88 (CI 0.82-0.93). The RBPF of FLs demonstrated stronger magnitudes of correlation with neuropsychological functioning, disability and quantitative MRI lesion measures than RBPV. These differences were statistically significant: P=0.001 for Stroop Color Word Interference test, P=0.001 for Paced Auditory Serial Addition Test, P=0.04 for Standard Raven Progressive Matrices, P=0.049 for Expanded Disability Status Scale, P=0.01 for T2-LL of FLs and P< 0.001 for T1-LL of FLs. BPF demonstrated significant correlations with tests assessing cognitive functions, whereas BPAV did not. The correlation analysis results were supported by the results of multiple regression analysis which showed that only the normalized brain atrophy measures were associated with tests exploring the cognitive functions. These data suggest that RBPF is a reproducible and sensitive method for measuring frontal parenchymal atrophy. The normalized measures of whole and regional brain parenchymal atrophy should be preferred to absolute measures in future studies that correlate neuropsychological performances and brain atrophy measures in patients with MS.

Key Words: cognitive function • frontal brain atrophy • MRI • multiple sclerosis • normalized measures

Multiple Sclerosis, Vol. 10, No. 5, 562-568 (2004)
DOI: 10.1191/1352458504ms1093oa


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				R. Zivadinov, L. Locatelli, D. Cookfair, B. Srinivasaraghavan, A. Bertolotto, M. Ukmar, A. Bratina, C. Maggiore, A. Bosco, A. Grop, et al. I nterferon beta-1a slows progression of brain atrophy in relapsing-remitting multiple sclerosis predominantly by reducing gray matter atrophy Multiple Sclerosis, May 1, 2007; 13(4): 490 - 501. [Abstract] [PDF]

				L. Bo, J. J. G. Geurts, P. van der Valk, C. Polman, and F. Barkhof Lack of Correlation Between Cortical Demyelination and White Matter Pathologic Changes in Multiple Sclerosis Arch Neurol, January 1, 2007; 64(1): 76 - 80. [Abstract] [Full Text] [PDF]

				H Hildebrandt, H K Hahn, J A Kraus, A Schulte-Herbruggen, B Schwarze, and G Schwendemann Memory performance in multiple sclerosis patients correlates with central brain atrophy Multiple Sclerosis, August 1, 2006; 12(4): 428 - 436. [Abstract] [PDF]

				R. H. B. Benedict, R. Zivadinov, D. A. Carone, B. Weinstock-Guttman, J. Gaines, C. Maggiore, J. Sharma, M.-A. Tomassi, and R. Bakshi Regional Lobar Atrophy Predicts Memory Impairment in Multiple Sclerosis AJNR Am. J. Neuroradiol., August 1, 2005; 26(7): 1824 - 1831. [Abstract] [Full Text] [PDF]