Clinical relevance of brain volume measures in multiple sclerosis.

De Stefano, Nicola; Airas, Laura; Grigoriadis, Nikolaos; Mattle, Heinrich P.; O'Riordan, Jonathan; Oreja-Guevara, Celia; Sellebjerg, Finn; Stankoff, Bruno; Walczak, Agata; Wiendl, Heinz; Kieseier, Bernd C (2014). Clinical relevance of brain volume measures in multiple sclerosis. CNS drugs, 28(2), pp. 147-156. Springer 10.1007/s40263-014-0140-z

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Mattle, Heinrich

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1172-7047

Publisher:

Springer

Language:

English

Submitter:

Valentina Rossetti

Date Deposited:

25 Sep 2014 14:14

Last Modified:

25 Sep 2014 14:14

Publisher DOI:

10.1007/s40263-014-0140-z

PubMed ID:

24446248

URI:

https://boris.unibe.ch/id/eprint/53284

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