MAGNIMS consensus recommendations on the use of brain and spinal cord atrophy measures in clinical practice: Nature Reviews Neurology

J. Sastre-Garriga, D. Pareto, M. Battaglini, M.A. Rocca, O. Ciccarelli, C. Enzinger, J. Wuerfel, M.P. Sormani, F. Barkhof, T.A. Yousry, N. De Stefano, M. Tintoré, M. Filippi, C. Gasperini, L. Kappos, J. Río, J. Frederiksen, J. Palace, H. Vrenken, X. MontalbanÀ. Rovira, on behalf of the MAGNIMS study group

Research output: Contribution to journalArticlepeer-review


Early evaluation of treatment response and prediction of disease evolution are key issues in the management of people with multiple sclerosis (MS). In the past 20 years, MRI has become the most useful paraclinical tool in both situations and is used clinically to assess the inflammatory component of the disease, particularly the presence and evolution of focal lesions — the pathological hallmark of MS. However, diffuse neurodegenerative processes that are at least partly independent of inflammatory mechanisms can develop early in people with MS and are closely related to disability. The effects of these neurodegenerative processes at a macroscopic level can be quantified by estimation of brain and spinal cord atrophy with MRI. MRI measurements of atrophy in MS have also been proposed as a complementary approach to lesion assessment to facilitate the prediction of clinical outcomes and to assess treatment responses. In this Consensus statement, the Magnetic Resonance Imaging in MS (MAGNIMS) study group critically review the application of brain and spinal cord atrophy in clinical practice in the management of MS, considering the role of atrophy measures in prognosis and treatment monitoring and the barriers to clinical use of these measures. On the basis of this review, the group makes consensus statements and recommendations for future research. © 2020, The Author(s).
Original languageEnglish
Pages (from-to)171-182
Number of pages12
JournalNat. Rev. Neurol.
Issue number3
Publication statusPublished - 2020


  • alemtuzumab
  • cladribine
  • fingolimod
  • fumaric acid dimethyl ester
  • glatiramer
  • lamotrigine
  • natalizumab
  • ocrelizumab
  • recombinant beta interferon
  • teriflunomide
  • alcohol consumption
  • artifact
  • basal ganglion
  • brain atrophy
  • brain size
  • cingulate gyrus
  • clinical feature
  • clinical practice
  • cortical thickness (brain)
  • diagnostic accuracy
  • disease association
  • disease burden
  • disease severity
  • Expanded Disability Status Scale
  • gray matter
  • image analysis
  • image processing
  • image quality
  • image segmentation
  • magnetic field
  • multiple sclerosis
  • neuroimaging
  • nuclear magnetic resonance imaging
  • physical activity
  • postcentral gyrus
  • practice guideline
  • predictive value
  • primary motor cortex
  • priority journal
  • prognosis
  • Review
  • risk factor
  • sex difference
  • spinal cord atrophy
  • thalamus
  • treatment response
  • volumetry
  • white matter
  • atrophy
  • brain
  • clinical trial
  • consensus
  • diagnostic imaging
  • human
  • multicenter study
  • pathology
  • procedures
  • randomized controlled trial (topic)
  • severity of illness index
  • spinal cord
  • Atrophy
  • Brain
  • Consensus
  • Humans
  • Magnetic Resonance Imaging
  • Multiple Sclerosis
  • Practice Guidelines as Topic
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Severity of Illness Index
  • Spinal Cord


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