Clinical Relevance of Brain Volume Measures in Multiple Sclerosis
Top Cited Papers
- 22 January 2014
- journal article
- review article
- Published by Springer Science and Business Media LLC in CNS Drugs
- Vol. 28 (2), 147-156
- https://doi.org/10.1007/s40263-014-0140-z
Abstract
Multiple sclerosis (MS) is a chronic disease with an inflammatory and neurodegenerative pathology. Axonal loss and neurodegeneration occurs early in the disease course and may lead to irreversible neurological impairment. Changes in brain volume, observed from the earliest stage of MS and proceeding throughout the disease course, may be an accurate measure of neurodegeneration and tissue damage. There are a number of magnetic resonance imaging-based methods for determining global or regional brain volume, including cross-sectional (e.g. brain parenchymal fraction) and longitudinal techniques (e.g. SIENA [Structural Image Evaluation using Normalization of Atrophy]). Although these methods are sensitive and reproducible, caution must be exercised when interpreting brain volume data, as numerous factors (e.g. pseudoatrophy) may have a confounding effect on measurements, especially in a disease with complex pathological substrates such as MS. Brain volume loss has been correlated with disability progression and cognitive impairment in MS, with the loss of grey matter volume more closely correlated with clinical measures than loss of white matter volume. Preventing brain volume loss may therefore have important clinical implications affecting treatment decisions, with several clinical trials now demonstrating an effect of disease-modifying treatments (DMTs) on reducing brain volume loss. In clinical practice, it may therefore be important to consider the potential impact of a therapy on reducing the rate of brain volume loss. This article reviews the measurement of brain volume in clinical trials and practice, the effect of DMTs on brain volume change across trials and the clinical relevance of brain volume loss in MS.Keywords
This publication has 101 references indexed in Scilit:
- Relevance of Brain Lesion Location to Cognition in Relapsing Multiple SclerosisPLOS ONE, 2012
- Revisiting Brain Atrophy and Its Relationship to Disability in Multiple SclerosisPLOS ONE, 2012
- Midlife vascular risk factor exposure accelerates structural brain aging and cognitive declineNeurology, 2011
- MRI predictors of cognitive outcome in early multiple sclerosisNeurology, 2011
- Association of matrix metalloproteinases with MRI indices of brain ischemia and agingNeurobiology of Aging, 2010
- New approaches in the management of multiple sclerosisDrug Design, Development and Therapy, 2010
- Mechanisms of neuronal dysfunction and degeneration in multiple sclerosisProgress in Neurobiology, 2010
- Smoking is associated with increased lesion volumes and brain atrophy in multiple sclerosisNeurology, 2009
- Magnetization transfer ratio abnormalities reflect clinically relevant grey matter damage in multiple sclerosisMultiple Sclerosis Journal, 2009
- Mechanisms of action of disease-modifying agents and brain volume changes in multiple sclerosisNeurology, 2008