Brain atrophy and lesion load in a large population of patients with multiple sclerosis.
OBJECTIVE
To measure white matter (WM) and gray matter (GM) atrophy and lesion load in a large population of patients with multiple sclerosis (MS) using a fully automated, operator-independent, multiparametric segmentation method.


METHODS
The study population consisted of 597 patients with MS and 104 control subjects. The MRI parameters were abnormal WM fraction (AWM-f), global WM-f (gWM-f), and GM fraction (GM-f).


RESULTS
Significant differences between patients with MS and control subjects included higher AWM-f and reduced gWM-f and GM-f. MRI data showed significant differences between patients with relapsing-remitting and secondary progressive forms of MS. Significant correlations between MRI parameters and between MRI and clinical data were found.


CONCLUSIONS
Patients with multiple sclerosis have significant atrophy of both white matter (WM) and gray matter (GM); secondary progressive patients have significantly more atrophy of both WM and GM than do relapsing-remitting patients and a significantly higher lesion load (abnormal WM fraction); lesion load is related to both WM and even more to GM atrophy; lesion load and WM and GM atrophy are significantly related to Expanded Disability Status Scale score and age at onset (suggesting that the younger the age at disease onset, the worse the lesion load and brain atrophy); and GM atrophy is the most significant MRI variable in determining the final disability.
Tedeschi
G
G
Department of Neurological Sciences, Second University of Naples, Piazza Miraglia 2, 80138 Naples, Italy. gioacchino.tedeschi@unina2.it
Lavorgna
L
L
Russo
P
P
Prinster
A
A
Dinacci
D
D
Savettieri
G
G
Quattrone
A
A
Livrea
P
P
Messina
C
C
Reggio
A
A
Bresciamorra
V
V
Orefice
G
G
Paciello
M
M
Brunetti
A
A
Coniglio
G
G
Bonavita
S
S
Di Costanzo
A
A
Bellacosa
A
A
Valentino
P
P
Quarantelli
M
M
Patti
F
F
Salemi
G
G
Cammarata
E
E
Simone
I L
IL
Salvatore
M
M
Bonavita
V
V
Alfano
B
B
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001284:Atrophy / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D001931:Brain Mapping; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004522:Educational Status; D005260:Female; D006801:Humans; D016899:Interferon-beta / Q000627:therapeutic use; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012737:Sex Factors
D016899:Interferon-beta