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Brain atrophy evolution and lesion load accrual in multiple sclerosis: a 2-year follow-up study

¹ Department of Neurological Sciences, Second University of Naples, Naples, Italy; Institute Hermitage Capodimonte, Naples, Italy
² Department of Neurological Sciences, Second University of Naples, Naples, Italy
³ Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
⁴ Department of Neurology, University of Palermo, Palermo, Italy
⁵ Department of Neurology, University of Catanzaro, Catanzaro, Italy
⁶ Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
⁷ Department of Neurology, University of Catania, Catania, Italy
⁸ Department of Neurological Sciences, University of Naples "Federico II," Naples, Italy
⁹ Department of Neurology, San Carlo Hospital, Potenza, Italy
¹⁰ Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy; Department of Diagnostic Imaging, University of Naples "Federico II," Naples, Italy
¹¹ Institute Hermitage Capodimonte, Naples, Italy; Department of Neurological Sciences, University of Naples "Federico II," Naples, Italy

^* To whom correspondence should be addressed.

	Abstract

Background

To investigate in a large cohort of patients with multiple sclerosis (MS), lesion load and atrophy evolution, and the relationship between clinical and magnetic resonance imaging (MRI) correlates of disease progression.

Methods

Two hundred and sixty-seven patients with MS were studied at baseline and two years later using the same MRI protocol. Abnormal white matter fraction, normal appearing white matter fraction, global white matter fraction, gray matter fraction and whole brain fraction, T2-hyperintense, and T1-hypointense lesions were measured at both time points.

Results

The majority of patients were clinically stable, whereas MRI-derived brain tissue fractions were significantly different after 2 years. The correlation between MRI data at baseline and their variation during the follow-up showed that lower basal gray matter atrophy was significantly related with higher progression of gray matter atrophy during follow-up. The correlation between MRI parameters and disease duration showed that gray matter atrophy rate decreased with increasing disease duration, whereas the rate of white matter atrophy had a constant pattern. Lower basal gray matter atrophy was associated with increased probability of developing gray matter atrophy at follow-up, whereas gray matter atrophy progression over 2 years and new T2 lesion load were risk factors for whole brain atrophy progression.

Conclusions

In MS, brain atrophy occurs even after a relatively short period of time and in patients with limited progression of disability. Short-term brain atrophy progression rates differ across tissue compartments, as gray matter atrophy results more pronounced than white matter atrophy and appears to be a early phenomenon in the MS-related disease progression.

Key Words: atrophy, MRI, multiple sclerosis, T2 lesions

First published on November 5, 2008, doi:10.1177/1352458508098270

Multiple Sclerosis 2009;15:204.

A more recent version of this article appeared on February 1, 2009


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