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Combined analysis of global and compartmental brain volume changes in early multiple sclerosis in clinical practice.
Mult Scler 2016; 22(3):340-6MS

Abstract

BACKGROUND

The extent and clinical significance of brain volume changes in different phases of multiple sclerosis (MS) is still under discussion.

OBJECTIVE

To determine the rate of global and compartmental brain volume changes in patients with a clinically-isolated syndrome (CIS) compared to patients with definite MS, by long-term follow-up and as a predictor of conversion to MS in a routine clinical setting.

METHODS

We investigated 120 patients (63 CIS and 57 MS) at baseline and after a mean follow-up period of 43 months, including detailed clinical examination and 3-Tesla magnetic resonance imaging (MRI). Our imaging analyses comprised the normalized brain volume (NBV), cortical grey matter (cGMV) and white matter (WMV) volumes using SIENA/X, the percentage of brain volume change (PBVC) using SIENA and the change in the volume of the thalami (TV) and basal ganglia (BGV). We also determined the amount and change of T2-lesion load (T2-LL).

RESULTS

At baseline, all the brain volume metrics, except cGMV, were significantly lower; and the T2-LL was significantly higher, in patients with MS rather than CIS. During the follow-up, only the PBVC was higher in MS (p = 0.008) and this difference was driven by converters from CIS to MS. Quartiles of PBVC did not allow us to predict conversion to MS, but were associated with the degree of disability.

CONCLUSIONS

PBVC is the most sensitive marker of progressing atrophy and a higher PBVC was generally associated with more active disease; however, it did not serve to predict the course of MS on an individual basis, in this study.

Authors+Show Affiliations

Medical University of Graz, Austria alexander.pichler@medunigraz.at.Medical University of Graz, Austria.Medical University of Graz, Austria.Medical University of Graz, Austria.Medical University of Graz, Austria.Medical University of Graz, Austria.Medical University of Graz, Austria.Medical University of Graz, Austria.Medical University of Graz, Austria.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26163072

Citation

Pichler, A, et al. "Combined Analysis of Global and Compartmental Brain Volume Changes in Early Multiple Sclerosis in Clinical Practice." Multiple Sclerosis (Houndmills, Basingstoke, England), vol. 22, no. 3, 2016, pp. 340-6.
Pichler A, Khalil M, Langkammer C, et al. Combined analysis of global and compartmental brain volume changes in early multiple sclerosis in clinical practice. Mult Scler. 2016;22(3):340-6.
Pichler, A., Khalil, M., Langkammer, C., Pinter, D., Bachmaier, G., Ropele, S., ... Fazekas, F. (2016). Combined analysis of global and compartmental brain volume changes in early multiple sclerosis in clinical practice. Multiple Sclerosis (Houndmills, Basingstoke, England), 22(3), pp. 340-6. doi:10.1177/1352458515593405.
Pichler A, et al. Combined Analysis of Global and Compartmental Brain Volume Changes in Early Multiple Sclerosis in Clinical Practice. Mult Scler. 2016;22(3):340-6. PubMed PMID: 26163072.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined analysis of global and compartmental brain volume changes in early multiple sclerosis in clinical practice. AU - Pichler,A, AU - Khalil,M, AU - Langkammer,C, AU - Pinter,D, AU - Bachmaier,G, AU - Ropele,S, AU - Fuchs,S, AU - Enzinger,C, AU - Fazekas,F, Y1 - 2015/07/10/ PY - 2015/02/16/received PY - 2015/05/31/accepted PY - 2015/7/12/entrez PY - 2015/7/15/pubmed PY - 2016/12/15/medline KW - Brain volume KW - clinical outcome KW - clinically-isolated syndrome KW - disability KW - disease prediction KW - disease progression KW - magnetic resonance imaging KW - multiple sclerosis SP - 340 EP - 6 JF - Multiple sclerosis (Houndmills, Basingstoke, England) JO - Mult. Scler. VL - 22 IS - 3 N2 - BACKGROUND: The extent and clinical significance of brain volume changes in different phases of multiple sclerosis (MS) is still under discussion. OBJECTIVE: To determine the rate of global and compartmental brain volume changes in patients with a clinically-isolated syndrome (CIS) compared to patients with definite MS, by long-term follow-up and as a predictor of conversion to MS in a routine clinical setting. METHODS: We investigated 120 patients (63 CIS and 57 MS) at baseline and after a mean follow-up period of 43 months, including detailed clinical examination and 3-Tesla magnetic resonance imaging (MRI). Our imaging analyses comprised the normalized brain volume (NBV), cortical grey matter (cGMV) and white matter (WMV) volumes using SIENA/X, the percentage of brain volume change (PBVC) using SIENA and the change in the volume of the thalami (TV) and basal ganglia (BGV). We also determined the amount and change of T2-lesion load (T2-LL). RESULTS: At baseline, all the brain volume metrics, except cGMV, were significantly lower; and the T2-LL was significantly higher, in patients with MS rather than CIS. During the follow-up, only the PBVC was higher in MS (p = 0.008) and this difference was driven by converters from CIS to MS. Quartiles of PBVC did not allow us to predict conversion to MS, but were associated with the degree of disability. CONCLUSIONS: PBVC is the most sensitive marker of progressing atrophy and a higher PBVC was generally associated with more active disease; however, it did not serve to predict the course of MS on an individual basis, in this study. SN - 1477-0970 UR - https://www.unboundmedicine.com/medline/citation/26163072/Combined_analysis_of_global_and_compartmental_brain_volume_changes_in_early_multiple_sclerosis_in_clinical_practice_ L2 - http://journals.sagepub.com/doi/full/10.1177/1352458515593405?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -