Background: Brain atrophy, in excess of that seen with normal aging, has been observed early in the clinical course of relapsing-remitting multiple sclerosis (RRMS). Previous work has suggested that at this stage of t...Background: Brain atrophy, in excess of that seen with normal aging, has been observed early in the clinical course of relapsing-remitting multiple sclerosis (RRMS). Previous work has suggested that at this stage of the disease, gray mat ter (GM) atrophy progresses more rapidly than the white matter (WM) atrophy. Obj ectives: To characterize the evolution of GM and WM volumes over 2 years, and th eir associations with lesion loads in a cohort of patients with clinically early RRMS. Methods: Twenty-one patients with RRMS (mean age 37.5 years, mean diseas e duration from symptom onset 2.1 years) and 10 healthy control subjects (mean a ge 37.1 years)-were studied. Tissue volumes, as fractions of total intracranial volumes, were estimated at baseline and 1-and 2-year follow-up. Brain parenc hymal fractions (BPF), GM fractions (GMF), and WM fractions (WMF) were estimated . In subjects with MS, brain lesion loads were determined on conventional T2-we ighted along with pre-and post-gadolinium (Gd) enhanced T1-weighted images at each timepoint. Results: A decrease in GMF was observed in subjects with MS vs normal controls over the 2 years of the study (mean -2.1%vs -1.0%, p=0.044), while no change was seen in WMF over the same period (mean -0.09%vs +0.09%, p=0.812). However, when the MS cohort was divided in half, dependent upon chang e in Gd-enhancing lesion load over 2 years (n=20), a decrease in WMF was seen i n the group (n=10) with the largest decline in Gd volume, whereas WMF increased in the other half (n=10) concurrent with a net increase in volume of Gd-enhanci ng lesions (difference between groups: p=0.034). Conclusions: Increasing gray ma tter but not white matter (WM) atrophy was observed early in the clinical course of relapsing-remitting multiple sclerosis. Fluctuations in inflammatory WM les ions appear to be related to volume changes in WM over this time period.展开更多
文摘Background: Brain atrophy, in excess of that seen with normal aging, has been observed early in the clinical course of relapsing-remitting multiple sclerosis (RRMS). Previous work has suggested that at this stage of the disease, gray mat ter (GM) atrophy progresses more rapidly than the white matter (WM) atrophy. Obj ectives: To characterize the evolution of GM and WM volumes over 2 years, and th eir associations with lesion loads in a cohort of patients with clinically early RRMS. Methods: Twenty-one patients with RRMS (mean age 37.5 years, mean diseas e duration from symptom onset 2.1 years) and 10 healthy control subjects (mean a ge 37.1 years)-were studied. Tissue volumes, as fractions of total intracranial volumes, were estimated at baseline and 1-and 2-year follow-up. Brain parenc hymal fractions (BPF), GM fractions (GMF), and WM fractions (WMF) were estimated . In subjects with MS, brain lesion loads were determined on conventional T2-we ighted along with pre-and post-gadolinium (Gd) enhanced T1-weighted images at each timepoint. Results: A decrease in GMF was observed in subjects with MS vs normal controls over the 2 years of the study (mean -2.1%vs -1.0%, p=0.044), while no change was seen in WMF over the same period (mean -0.09%vs +0.09%, p=0.812). However, when the MS cohort was divided in half, dependent upon chang e in Gd-enhancing lesion load over 2 years (n=20), a decrease in WMF was seen i n the group (n=10) with the largest decline in Gd volume, whereas WMF increased in the other half (n=10) concurrent with a net increase in volume of Gd-enhanci ng lesions (difference between groups: p=0.034). Conclusions: Increasing gray ma tter but not white matter (WM) atrophy was observed early in the clinical course of relapsing-remitting multiple sclerosis. Fluctuations in inflammatory WM les ions appear to be related to volume changes in WM over this time period.
