Abstract
Objective: To investigate the in-vivo correlates of brain atrophy in patients with multiple sclerosis (MS) by assessing the relationship between normalized measures of brain volume (NBV) and other magnetic resonance (MR) measures of tissue damage. Background: Brain atrophy diffusely occurs and progressively increases in patients with MS. Nevertheless, the mechanisms leading to brain atrophy in this disease are not fully understood. Methods: MR examinations were performed in 20 patients with relapsing-remitting MS. Conventional MRI was used to assess NBV and total brain T2-hyper-intense and T1-hypointense lesion volumes. Proton MR spectroscopic imaging and diffusion tensor MR imaging were also performed for large portions of brain containing mainly normal-appearing tissue to provide indices of tissue damage, including N-acetylaspartate to creatine ratio (NAA/Cr) and mean diffusivity (D̄). Results: Values of NBV correlated significantly with those of average brain D̄ (r = -0.58, p = 0.007) and NAA/Cr (r = 0.67, p <0.001). The relationship of these markers of tissue damage to NBV was also found when NAA/Cr and D̄ were computed together in a composite MR score (r = 0.70, p <0.001). In contrast, NBV values did not correlate with measurements of average lesion D̄, T2 and T1 weighted total brain MRI lesion volumes. Conclusions: This study suggests that brain atrophy in MS is not simply due to axonal loss, but rather reflects a more generalized process that involves various brain tissue components. Damage to the normal-appearing tissue rather than the extent and intrinsic pathology of macroscopic lesions seems to be important in the destructive process leading to MS-related irreversible cerebral atrophy.
| Original language | English |
|---|---|
| Pages (from-to) | 1072-1077 |
| Number of pages | 6 |
| Journal | Journal of Neurology |
| Volume | 249 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 2002 |
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Keywords
- Axonal damage
- Brain atrophy
- Diffusion
- Magnetic resonance spectroscopy
- Multiple sclerosis
ASJC Scopus subject areas
- Clinical Neurology
- Neurology
Cite this
MR correlates of cerebral atrophy in patients with multiple sclerosis. / De Stefano, Nicola; Iannucci, Giuseppe; Sormani, Maria P.; Guidi, Leonello; Bartolozzi, Maria L.; Comi, Giancarlo; Federico, Antonio; Filippi, Massimo.
In: Journal of Neurology, Vol. 249, No. 8, 2002, p. 1072-1077.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - MR correlates of cerebral atrophy in patients with multiple sclerosis
AU - De Stefano, Nicola
AU - Iannucci, Giuseppe
AU - Sormani, Maria P.
AU - Guidi, Leonello
AU - Bartolozzi, Maria L.
AU - Comi, Giancarlo
AU - Federico, Antonio
AU - Filippi, Massimo
PY - 2002
Y1 - 2002
N2 - Objective: To investigate the in-vivo correlates of brain atrophy in patients with multiple sclerosis (MS) by assessing the relationship between normalized measures of brain volume (NBV) and other magnetic resonance (MR) measures of tissue damage. Background: Brain atrophy diffusely occurs and progressively increases in patients with MS. Nevertheless, the mechanisms leading to brain atrophy in this disease are not fully understood. Methods: MR examinations were performed in 20 patients with relapsing-remitting MS. Conventional MRI was used to assess NBV and total brain T2-hyper-intense and T1-hypointense lesion volumes. Proton MR spectroscopic imaging and diffusion tensor MR imaging were also performed for large portions of brain containing mainly normal-appearing tissue to provide indices of tissue damage, including N-acetylaspartate to creatine ratio (NAA/Cr) and mean diffusivity (D̄). Results: Values of NBV correlated significantly with those of average brain D̄ (r = -0.58, p = 0.007) and NAA/Cr (r = 0.67, p <0.001). The relationship of these markers of tissue damage to NBV was also found when NAA/Cr and D̄ were computed together in a composite MR score (r = 0.70, p <0.001). In contrast, NBV values did not correlate with measurements of average lesion D̄, T2 and T1 weighted total brain MRI lesion volumes. Conclusions: This study suggests that brain atrophy in MS is not simply due to axonal loss, but rather reflects a more generalized process that involves various brain tissue components. Damage to the normal-appearing tissue rather than the extent and intrinsic pathology of macroscopic lesions seems to be important in the destructive process leading to MS-related irreversible cerebral atrophy.
AB - Objective: To investigate the in-vivo correlates of brain atrophy in patients with multiple sclerosis (MS) by assessing the relationship between normalized measures of brain volume (NBV) and other magnetic resonance (MR) measures of tissue damage. Background: Brain atrophy diffusely occurs and progressively increases in patients with MS. Nevertheless, the mechanisms leading to brain atrophy in this disease are not fully understood. Methods: MR examinations were performed in 20 patients with relapsing-remitting MS. Conventional MRI was used to assess NBV and total brain T2-hyper-intense and T1-hypointense lesion volumes. Proton MR spectroscopic imaging and diffusion tensor MR imaging were also performed for large portions of brain containing mainly normal-appearing tissue to provide indices of tissue damage, including N-acetylaspartate to creatine ratio (NAA/Cr) and mean diffusivity (D̄). Results: Values of NBV correlated significantly with those of average brain D̄ (r = -0.58, p = 0.007) and NAA/Cr (r = 0.67, p <0.001). The relationship of these markers of tissue damage to NBV was also found when NAA/Cr and D̄ were computed together in a composite MR score (r = 0.70, p <0.001). In contrast, NBV values did not correlate with measurements of average lesion D̄, T2 and T1 weighted total brain MRI lesion volumes. Conclusions: This study suggests that brain atrophy in MS is not simply due to axonal loss, but rather reflects a more generalized process that involves various brain tissue components. Damage to the normal-appearing tissue rather than the extent and intrinsic pathology of macroscopic lesions seems to be important in the destructive process leading to MS-related irreversible cerebral atrophy.
KW - Axonal damage
KW - Brain atrophy
KW - Diffusion
KW - Magnetic resonance spectroscopy
KW - Multiple sclerosis
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U2 - 10.1007/s00415-002-0790-5
DO - 10.1007/s00415-002-0790-5
M3 - Article
VL - 249
SP - 1072
EP - 1077
JO - Journal of Neurology
JF - Journal of Neurology
SN - 0340-5354
IS - 8
ER -