Progressive cerebral atrophy in MS: a serial study using registered, volumetric MRI
Version 2 2024-06-03, 18:16Version 2 2024-06-03, 18:16
Version 1 2019-07-18, 15:14Version 1 2019-07-18, 15:14
journal contribution
posted on 2024-06-03, 18:16authored byNC Fox, R Jenkins, SM Leary, VL Stevenson, NA Losseff, WR Crum, Richard HarveyRichard Harvey, MN Rossor, DH Miller, AJ Thompson
Objective: To assess the potential of registered volumetric MRI in measuring rates of atrophy in MS. Background: Pathologic and imaging studies suggest that the development of permanent neurologic impairment in MS is associated with progressive brain and spinal cord atrophy. Atrophy has been suggested as a potential marker of disease progression. Conventional atrophy measurements requiring manual outlining are time-consuming and subject to reproducibility problems. Registration of serial MRI may offer a useful alternative in that cerebral losses may be measured directly from automated subtraction of brain volumes. Methods: Twenty-six patients with MS and 26 age- and gender-matched controls had two volumetric brain MR studies 1 year apart. Baseline brain and ventricular volumes were measured using semi- automated techniques, and follow-up scans were registered to baseline. Rates of cerebral atrophy were calculated directly from the registered scans. Results: Baseline brain volumes in the MS group were smaller (mean difference 78 mL [95% CI 13 to 143; p = 0.02]) and ventricular volumes greater (mean difference 12 mL [95% CI 6 to 18; p < 0.001]) than controls. The rate of cerebral atrophy in the MS group (0.8% per year) was over twice that of controls (0.3%), and the rate of ventricular enlargement was five times greater than the controls (1.6 versus 0.3 mL/year). Conclusion: Progressive cerebral atrophy is an important feature of MS. Registration-based measurements are sensitive and reproducible, allowing progressive atrophy to be detected within 1 year and may have potential as a marker of progression in monitoring therapeutic trials.