MR correlates of cerebral atrophy in patients with multiple sclerosis

Nicola De Stefano, Giuseppe Iannucci, Maria P. Sormani, Leonello Guidi, Maria L. Bartolozzi, Giancarlo Comi, Antonio Federico, Massimo Filippi

Research output: Contribution to journalArticle

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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 languageEnglish
Pages (from-to)1072-1077
Number of pages6
JournalJournal of Neurology
Volume249
Issue number8
DOIs
Publication statusPublished - 2002

Fingerprint

Multiple Sclerosis
Atrophy
Magnetic Resonance Spectroscopy
Brain
Creatine
Relapsing-Remitting Multiple Sclerosis
Diffusion Magnetic Resonance Imaging
Protons
Magnetic Resonance Imaging
Pathology

Keywords

  • Axonal damage
  • Brain atrophy
  • Diffusion
  • Magnetic resonance spectroscopy
  • Multiple sclerosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

De Stefano, N., Iannucci, G., Sormani, M. P., Guidi, L., Bartolozzi, M. L., Comi, G., ... Filippi, M. (2002). MR correlates of cerebral atrophy in patients with multiple sclerosis. Journal of Neurology, 249(8), 1072-1077. https://doi.org/10.1007/s00415-002-0790-5

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 journalArticle

De Stefano, N, Iannucci, G, Sormani, MP, Guidi, L, Bartolozzi, ML, Comi, G, Federico, A & Filippi, M 2002, 'MR correlates of cerebral atrophy in patients with multiple sclerosis', Journal of Neurology, vol. 249, no. 8, pp. 1072-1077. https://doi.org/10.1007/s00415-002-0790-5
De Stefano N, Iannucci G, Sormani MP, Guidi L, Bartolozzi ML, Comi G et al. MR correlates of cerebral atrophy in patients with multiple sclerosis. Journal of Neurology. 2002;249(8):1072-1077. https://doi.org/10.1007/s00415-002-0790-5
De Stefano, Nicola ; Iannucci, Giuseppe ; Sormani, Maria P. ; Guidi, Leonello ; Bartolozzi, Maria L. ; Comi, Giancarlo ; Federico, Antonio ; Filippi, Massimo. / MR correlates of cerebral atrophy in patients with multiple sclerosis. In: Journal of Neurology. 2002 ; Vol. 249, No. 8. pp. 1072-1077.
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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.",
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AU - Iannucci, Giuseppe

AU - Sormani, Maria P.

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AU - Comi, Giancarlo

AU - Federico, Antonio

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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.

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