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Extent of brain involvement at MS diagnosis telling
Monday, 29 November 1999 19:00 | 
| Radiology News - Radiology Articles |
In patients with recently diagnosed multiple sclerosis, the extent of brain tissue loss and lesion burden may predict the rate of new brain atrophy.
In patients with recently diagnosed multiple sclerosis, the extent of accumulated brain tissue loss and overall lesion burden early in the disease course may predict the rate of new brain atrophy over the following two years, according to Dutch researchers.
In addition to the typical MS lesions, subtle and diffuse destructive processes in apparently normal brain tissue are responsible for the rate at which such tissue damage accumulates, the investigators report in the February issue of Archives of Neurology.
Dr. Bas Jasperse and colleagues from VU University Medical Center, Amsterdam performed brain magnetic resonance imaging shortly after diagnosis and again 24 months later in 89 patients whose average age was 37.5 years.
"The key observation," Dr. Jasperse told Reuters Health, "is that multiple sclerosis patients who have lost more brain tissue and have accumulated more lesions very early in the disease course are prone to lose more brain tissue in subsequent years."
"As loss of brain tissue is considered to be the underlying cause of irreversible clinical disability, our findings suggest that brain volume and lesion burden could have clinical prognostic value at long term follow-up," the investigator added.
The average annualized rate of brain atrophy was -0.9 percentage of brain volume change (PBVC) per year, the team reports. Initial normalized brain volume and initial T2 lesion load explained the subsequent PBVC per year and also yielded a regression model that accounted for 31.2 per cent of the variance in PBVC per year.
"We could only explain one third of the rate of brain tissue loss," Dr. Jasperse noted, "and the extent of brain tissue loss early in the disease course seemed more important than the accumulation of lesions. This suggests that a more diffuse and subtle destructive process is also responsible for the rate of brain tissue loss in addition to the readily observable MS lesions".
Dr. J. Theodore Phillips of The Multiple Sclerosis Center at Texas Neurology, Dallas writes in an accompanying editorial that the finding provides "not only important clinical prognostic information, but also indicates the necessity of accounting for these baseline MRI variables in future clinical study designs that use brain atrophy as an outcome variable".
Arch Neuro 2007;64:167-168,190-194.
In addition to the typical MS lesions, subtle and diffuse destructive processes in apparently normal brain tissue are responsible for the rate at which such tissue damage accumulates, the investigators report in the February issue of Archives of Neurology.
Dr. Bas Jasperse and colleagues from VU University Medical Center, Amsterdam performed brain magnetic resonance imaging shortly after diagnosis and again 24 months later in 89 patients whose average age was 37.5 years.
"The key observation," Dr. Jasperse told Reuters Health, "is that multiple sclerosis patients who have lost more brain tissue and have accumulated more lesions very early in the disease course are prone to lose more brain tissue in subsequent years."
"As loss of brain tissue is considered to be the underlying cause of irreversible clinical disability, our findings suggest that brain volume and lesion burden could have clinical prognostic value at long term follow-up," the investigator added.
The average annualized rate of brain atrophy was -0.9 percentage of brain volume change (PBVC) per year, the team reports. Initial normalized brain volume and initial T2 lesion load explained the subsequent PBVC per year and also yielded a regression model that accounted for 31.2 per cent of the variance in PBVC per year.
"We could only explain one third of the rate of brain tissue loss," Dr. Jasperse noted, "and the extent of brain tissue loss early in the disease course seemed more important than the accumulation of lesions. This suggests that a more diffuse and subtle destructive process is also responsible for the rate of brain tissue loss in addition to the readily observable MS lesions".
Dr. J. Theodore Phillips of The Multiple Sclerosis Center at Texas Neurology, Dallas writes in an accompanying editorial that the finding provides "not only important clinical prognostic information, but also indicates the necessity of accounting for these baseline MRI variables in future clinical study designs that use brain atrophy as an outcome variable".
Arch Neuro 2007;64:167-168,190-194.
