Progressive cerebral atrophy in MS: A serial study using registered, volumetric MRI

N C Fox, R Jenkins, S M Leary, V L Stevenson, N A Losseff, W R Crum, R J Harvey, M N Rossor, D H Miller, A J Thompson

Research output: Contribution to journalLetterpeer-review

194 Citations (Scopus)

Abstract

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 semiautomated 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.
Original languageEnglish
Pages (from-to)807-812
Number of pages6
JournalNeurology
Volume54
Issue number4
DOIs
Publication statusPublished - 22 Feb 2000

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