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A longitudinal study of MRI-detected atrophy in secondary progressive multiple sclerosis

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Abstract

MRI measures of tissue atrophy within the central nervous system may reflect the neurodegenerative process which underpins the progressive phase of multiple sclerosis (MS). There has been limited longitudinal investigation of MRI-detected atrophy in secondary progressive MS. This study includes 56 subjects with secondary progressive MS. Subjects were followed up for 2 years and MRI analysis was conducted at 12 month intervals using the following measures: (1) whole brain (WB) volume change; (2) grey and white matter (WM) volumes; (3) central brain volume; (4) upper cervical spinal cord (SC) area; (5) T2 lesion volumes. Clinical measures included the Expanded Disability Status Scale and the MS Functional Composite. All volumetric MRI measures were assessed for sensitivity, responsiveness, reliability and correlation with disability. The mean annual atrophy rate of WB was 0.59% per year and this was the most responsive atrophy measure assessed. Grey matter (GM) atrophy (−1.18% per year) was greater and more responsive than WM atrophy (0.12% per year). The SC demonstrated the highest atrophy rate at 1.63% per year. WB, GM and SC atrophy all correlated with change in the Multiple Sclerosis Functional Composite z score (r = 0.35, 0.42, 0.34), and GM atrophy was the only correlate of change in the 9 Hole Peg Test and Paced Auditory Serial Addition Test performance. None of the MRI measures correlated with Expanded Disability Status Score progression. Measures of WB, GM and SC atrophy all have attributes for use as surrogate markers in secondary progressive MS trials and improvement in the reliability of the GM and SC volume measurements may enhance these further.

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Acknowledgments

This study was funded by the MS Society of Great Britain. The authors would like to thank the radiographers in the MS NMR Research Unit at the Institute of Neurology, London and Kelvin Hunter, IT administrator for the NMR trials unit, for providing technical support. We also thank Professor Nick Fox (Dementia Research Centre, Institute of Neurology) for providing analytical software and Professor Richard Hughes for supporting this research. This work was undertaken at UCLH/UCL who received a proportion of funding from the Department of Health’s NIHR Biomedical Research Centres funding scheme.

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Authors and Affiliations

  1. Department of Neuroinflammation, Institute of Neurology, Queen Square, London, WC1N 3BG, UK

    J. Furby, T. Hayton, K. J. Smith, D. H. Miller & R. Kapoor

  2. London School of Hygiene and Tropical Medicine, London, UK

    D. Altmann

  3. Department of Neurology, Royal Free Hospital, London, UK

    R. Brenner

  4. National Hospital for Neurology and Neurosurgery, London, UK

    J. Chataway

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  1. J. Furby
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Correspondence to J. Furby.

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Furby, J., Hayton, T., Altmann, D. et al. A longitudinal study of MRI-detected atrophy in secondary progressive multiple sclerosis. J Neurol 257, 1508–1516 (2010). https://doi.org/10.1007/s00415-010-5563-y

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  • DOI: https://doi.org/10.1007/s00415-010-5563-y

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