Clinical Relevance of Brain Volume Measures in Multiple Sclerosis (original) (raw)
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Critical analysis on the present methods for brain volume measurements in multiple sclerosis
Arquivos de Neuro-Psiquiatria, 2017
Objective The treatment of multiple sclerosis (MS) has quickly evolved from a time when controlling clinical relapses would suffice, to the present day, when complete disease control is expected. Measurement of brain volume is still at an early stage to be indicative of therapeutic decisions in MS. Methods This paper provides a critical review of potential biases and artifacts in brain measurement in the follow-up of patients with MS. Results Clinical conditions (such as hydration or ovulation), time of the day, type of magnetic resonance machine (manufacturer and potency), brain volume artifacts and different platforms for volumetric assessment of the brain can induce variations that exceed the acceptable physiological rate of annual loss of brain volume. Conclusion Although potentially extremely valuable, brain volume measurement still has to be regarded with caution in MS.
Correlation of clinical findings and brain volume data in multiple sclerosis
, on behalf of theBrazilian Brain Volume Studies (B-BRAVOS) group a b s t r a c t Brain volume measurements are becoming an important tool for assessing success in controlling multiple sclerosis (MS) activity. MSmetrix (icometrix) is an easy-to-use platform, specific for MS magnetic resonance imaging (MRI) of the brain. It provides data on total brain volume, grey matter volume and lesion load volume. The objective of the present study was to assess whether disability and the number of relapses during the previous year correlated with brain volume measurements from MSmetrix. Data on 185 icometrix reports from patients with MS were used to evaluate the potential correlation between brain volume measurements and clinical parameters. There was a significant correlation between higher disability and decreased brain volume (total and grey matter). Increased lesion load in the brain and higher number of relapses in the previous year were also independently correlated with decreased brain tissue volume and with increased disability. This is the first study with real-world data to show that icometrix is a relevant tool for the study of brain volume loss in MS.
Frontiers in Neurology
Purpose: Thalamic atrophy and whole brain atrophy in multiple sclerosis (MS) are associated with disease progression. The motivation of this study was to propose and evaluate a new grouping scheme which is based on MS patients' whole brain and thalamus volumes measured on MRI at a single time point. Methods: In total, 185 MS patients (128 relapsing-remitting (RRMS) and 57 secondary-progressive MS (SPMS) patients) were included from an outpatient facility. Whole brain parenchyma (BP) and regional brain volumes were derived from single time point MRI T1 images. Standard scores (z-scores) were computed by comparing individual brain volumes against corresponding volumes from healthy controls. A z-score cutoff of −1.96 was applied to separate pathologically atrophic from normal brain volumes for thalamus and whole BP (accepting a 2.5% error probability). Subgroup differences with respect to the Symbol Digit Modalities Test (SDMT) and the Expanded Disability Status Scale (EDSS) were assessed. Results: Except for two, all MS patients showed either no atrophy (group 0: 61 RRMS patients, 10 SPMS patients); thalamic but no BP atrophy (group 1: 37 RRMS patients; 18 SPMS patients) or thalamic and BP atrophy (group 2: 28 RRMS patients; 29 SPMS patients). RRMS patients without atrophy and RRMS patients with thalamic atrophy did not differ in EDSS, however, patients with thalamus and BP atrophy showed significantly higher EDSS scores than patients in the other groups. Conclusion: MRI-based brain volumetry at a single time point is able to reliably distinguish MS patients with isolated thalamus atrophy (group 1) from those without brain atrophy (group 0). MS patients with isolated thalamus atrophy might be at risk for the development of widespread atrophy and disease progression. Since RRMS patients in group 0 and 1 are clinically not distinguishable, the proposed grouping may aid identification of RRMS patients at risk of disease progression and thus complement clinical evaluation in the routine patient care.
Evaluation of Brain Volume Loss in Different Clinical Types of Multiple Sclerosis Patients
The Medical Journal of Cairo University, 2018
Background: Brain atrophy is an important imaging biomarker in predicting future disability and progression of disease in multiple sclerosis. Aim of Study: We need to evaluate brain volume loss in different clinical types of MS and correlates it with physical disability using NeuroQuaqnt 2.0 automated volumetric measurement of brain atrophy in MS. Material and Methods: We conducted the following study on 40 MS patients (4 CIS, 8 PPMS, 22 RRMS and 6 SPMS) for clinical evaluation, assessment their physical disability by (EDSS) and automated volumetric measurement of 3 parameters (whole brain, lateral ventricles and thalami volumes) by obtain 3D T1 non contrast, saggital MRI scan by using new software (NeuroQuant®2.0 automated volumetric measurement of brain atrophy) of MS patients. Results: Thalami atrophy was predominant atrophy in 24 patients. Also, it was predominant atrophy in different clinical types (2 CIS, 4 PPMS, 12 RRMS and 6 SPMS) patients. Morphometry results were correlated with physical disability (whole brain volume r=-0.400, p=0.026), (thalami volume r=-0.379, p=0.016), and (lateral ventricles volume r=0.365, p=0.044). MS patients with (disease duration >1 year) had significant lower whole brain volume (p=0.037), lower thalami volume (p=0.019) and higher lateral ventricles volumes (p=0.044). Conclusion: Thalami atrophy is a predominant atrophy in different clinical types of MS patients. Thalami atrophy may be used a sole indices in brain atrophy measuring. Brain atrophy correlates with physical disability and progress with duration of illness.
Assessing Biological and Methodological Aspects of Brain Volume Loss in Multiple Sclerosis
JAMA neurology, 2018
Before using brain volume loss (BVL) as a marker of therapeutic response in multiple sclerosis (MS), certain biological and methodological issues must be clarified. To assess the dynamics of BVL as MS progresses and to evaluate the repeatability and exchangeability of BVL estimates with Jacobian Integration (JI) and Functional Magnetic Resonance Imaging of the Brain (FMRIB) Software Library (FSL) (specifically, the Structural Image Evaluation, Using Normalisation, of Atrophy-Cross-Sectional [SIENA-X] tool or FMRIB's Integrated Registration and Segmentation Tool [FIRST]). A cohort of patients who had either clinically isolated syndrome or MS was enrolled from February 2011 through October 2015. All underwent a series of annual magnetic resonance imaging (MRI) scans. Images from 2 cohorts of healthy volunteers were used to evaluate short-term repeatability of the MRI measurements (n = 34) and annual BVL (n = 20). Data analysis occurred from January to May 2017. The goodness of fit...
Correlation between brain MRI lesion volume and disability in patients with multiple sclerosis
Acta Neurologica Scandinavica, 1996
Acta Neurol Scand 1996: 94: 93-96 Prinrcd in UKall rights reserved Copyrighr 0 Munksgaard 19% ACTA NEUROLOGICA SCANDINAVICA ISSN WOI -631 4 Correlation between brain MRI lesion volume and disability in patients with multiple sclerosis Mammi S, Filippi M, Martinelli V, Campi A, Colombo B, Scotti G, Canal N, Comi G. Correlation between brain MRI lesion volume and disability in patients with multiple sclerosis. Acta Neurol Scand 1995: 94: 93-96. 0 Munksgaard 1996.
Basic and Clinical Neuroscience Journal, 2023
Multiple sclerosis (MS) is an inflammatory demyelinating and neurodegenerative disorder of the central nervous system, which is associated with brain atrophy and volume changes in some brain structures. This study aimed to compare the volume of the basal ganglia, thalamus, cerebellum, and brainstem in patients with relapsing-remitting MS with that of the control group using magnetic resonance imaging (MRI). Methods: In this cross-sectional study, MRI brain scans were obtained from 25 patients with relapsing-remitting MS and 25 healthy control subjects. Volumetric analyses were performed using Brain Suite software. Results: The mean age of the MS and the control groups was 33.96±8.75 and 40.40±8.72, respectively. No statistically significant difference was found in gender (P=0.747). The bilateral putamen and caudate nuclei volumes were significantly higher in the case group than in the control group (P<0.001). Moreover, lower the volume of the brainstem, cerebellum, bilateral thalamus, and globus pallidus were identified in the MS patients compared to the control group (P<0.001). There was an inverse correlation between the disease and treatment duration with the thalamus and cerebellum volume in MS patients (P=0.001). Treatment duration also had an inverse correlation with brainstem volume (P=0.047). Conclusion: The volume of some structures of the brain, including globus pallidus, thalamus, cerebellum, and brainstem is lower in MS and can be one of the markers of disease progression and disability among MS patients.
Pathological cut-offs of global and regional brain volume loss in multiple sclerosis
Multiple sclerosis (Houndmills, Basingstoke, England), 2017
Volumetric MRI surrogate markers of disease progression are lacking. To establish cut-off values of brain volume loss able to discriminate between healthy controls and MS patients. In total, 386 patients after first demyelinating event suggestive of MS (CIS), 964 relapsing-remitting MS (RRMS) patients, 63 secondary-progressive MS (SPMS) patients and 58 healthy controls were included in this longitudinal study. A total of 11,438 MRI scans performed on the same MRI scanner with the same protocol were analysed. Annualised percentage changes of whole brain, grey matter, thalamus and corpus callosum volumes were estimated. We investigated cut-offs able to discriminate between healthy controls and MS patients. At a predefined specificity of 90%, the annualised percentage change cut-off of corpus callosum volume (-0.57%) was able to distinguish between healthy controls and patients with the highest sensitivity (51% in CIS, 48% in RRMS and 42% in SPMS patients). Lower sensitivities (22%-49%...
Association between brain volume and disability over time in multiple sclerosis
Multiple Sclerosis Journal - Experimental, Translational and Clinical
Background Most previous multiple sclerosis (MS) brain atrophy studies using MS impact scale 29 (MSIS-29) or symbol digit modalities test (SDMT) have been cross-sectional with limited sets of clinical outcomes. Objectives To investigate which brain and lesion volume metrics show the strongest long-term associations with the expanded disability status scale (EDSS), SDMT, and MSIS-29, and whether MRI-clinical associations vary with age. Methods We acquired MRI and clinical data from a real-world Swedish MS cohort. FreeSurfer and SPM Lesion Segmentation Tool were used to obtain brain parenchymal, cortical and subcortical grey matter, thalamic and white matter fractions as well as T1- and T2-lesion volumes. Mixed-effects and rolling regression models were used in the statistical analyses. Results We included 989 persons with MS followed for a median of 9.3 (EDSS), 10.1 (SDMT), and 9.3 (MSIS-29) years, respectively. In a cross-sectional analysis, the strength of the associations of the M...