American Journal of Neuroradiology 26:341-346, February 2005
© 2005 American Society of Neuroradiology
BRAIN
Regional Brain Atrophy Evolves Differently in Patients with Multiple Sclerosis According to Clinical Phenotype
a Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy
b Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Milan, Italy
Address reprint requests to Dr Massimo Filippi, Neuroimaging Research Unit Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Via Olgettina, 60, 20132 Milan, Italy
BACKGROUND AND PURPOSE: Progressive brain atrophy is a well-known feature of multiple sclerosis (MS). We characterized the spatial evolution of atrophy in different MS phenotypes.
METHODS: Dual-echo and T1-weighted MR images were obtained in 70 patients with MS and 10 healthy control subjects at entry and after 15 months. Within-group changes in regional atrophy were assessed by applying Structural Image Evaluation Using Normalization of Atrophy software and statistical parametric mapping analysis. Reported differences are for P <.001.
RESULTS: During follow-up, patients with relapsing-remitting MS (RRMS) differences significant atrophy around the ventricular system; pericerebellar spaces; cerebellar tentorium; putamen; corpus callosum; cingulate sulcus; hippocampus; parieto-occipital fissure; lateral fissure; and frontal, parietal, temporal, and occipital cortex. Patients with secondary progressive MS developed significant atrophy of the cingulate sulcus; pulvinar; caudate nucleus; anterior orbital gyrus; mammillary body; fourth ventricle; and regions of frontal, parietal, temporal, and occipital cortex. Patients with primary progressive MS developed significant atrophy of the bilateral central sulcus; caudate nucleus; prepontine and quadrigeminal cisterns; lateral ventricle; and regions of frontal, parietal, temporal, and occipital cortex. In all phenotypes, the development of atrophy in some regions was significantly correlated with the accumulation of T2- and T1-visible lesions and clinical disability (r = –0.57 to –0.86).
CONCLUSION: In MS, brain atrophy develops involving different structures in the different phenotypes. While ventricular enlargement is predominant in RRMS, cortical atrophy seems to be more important in the progressive forms. Measures of regional brain atrophy were significantly correlated with disability, suggesting that this approach is promising for bridging the gap between clinical and MR imaging findings in MS.
This article has been cited by other articles:
 |
|
 |
|
  D Bar-Zohar, F Agosta, D Goldstaub, and M Filippi Magnetic resonance imaging metrics and their correlation with clinical outcomes in multiple sclerosis: a review of the literature and future perspectives Multiple Sclerosis, July 1, 2008; 14(6): 719 - 727. [Abstract] [PDF]
|
|
|
|
 |
|
 C. Di Perri, M. Battaglini, M. L. Stromillo, M. L. Bartolozzi, L. Guidi, A. Federico, and N. De Stefano Voxel-Based Assessment of Differences in Damage and Distribution of White Matter Lesions Between Patients With Primary Progressive and Relapsing-Remitting Multiple Sclerosis Arch Neurol, February 1, 2008; 65(2): 236 - 243. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Calabrese, N. De Stefano, M. Atzori, V. Bernardi, I. Mattisi, L. Barachino, A. Morra, L. Rinaldi, C. Romualdi, P. Perini, et al. Detection of Cortical Inflammatory Lesions by Double Inversion Recovery Magnetic Resonance Imaging in Patients With Multiple Sclerosis Arch Neurol, October 1, 2007; 64(10): 1416 - 1422. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. K. Houtchens, R.H.B. Benedict, R. Killiany, J. Sharma, Z. Jaisani, B. Singh, B. Weinstock-Guttman, C. R.G. Guttmann, and R. Bakshi Thalamic atrophy and cognition in multiple sclerosis Neurology, September 18, 2007; 69(12): 1213 - 1223. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Juha, S. Leszek, F. Sten, H. Jan, B. Jakob, F. Olof, and K. W. Maria Progression of non-age-related callosal brain atrophy in multiple sclerosis: a 9-year longitudinal MRI study representing four decades of disease development J. Neurol. Neurosurg. Psychiatry, April 1, 2007; 78(4): 375 - 380. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Sepulcre, J. Sastre-Garriga, M. Cercignani, G. T. Ingle, D. H. Miller, and A. J. Thompson Regional Gray Matter Atrophy in Early Primary Progressive Multiple Sclerosis: A Voxel-Based Morphometry Study. Arch Neurol, August 1, 2006; 63(8): 1175 - 1180. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Dalton, K. A. Miszkiel, P. W. O'Connor, G. T. Plant, G.P.A. Rice, and D. H. Miller Ventricular enlargement in MS: One-year change at various stages of disease Neurology, March 14, 2006; 66(5): 693 - 698. [Abstract] [Full Text] [PDF]
|
|