title: Brain atrophy evolution and lesion load accrual in multiple sclerosis: a 2-year follow-up study.
abstract: BACKGROUND
  To investigate in a large cohort of patients with multiple sclerosis (MS), lesion load and atrophy evolution, and the relationship between clinical and magnetic resonance imaging (MRI) correlates of disease progression.
  
  
  METHODS
  Two hundred and sixty-seven patients with MS were studied at baseline and two years later using the same MRI protocol. Abnormal white matter fraction, normal appearing white matter fraction, global white matter fraction, gray matter fraction and whole brain fraction, T2-hyperintense, and T1-hypointense lesions were measured at both time points.
  
  
  RESULTS
  The majority of patients were clinically stable, whereas MRI-derived brain tissue fractions were significantly different after 2 years. The correlation between MRI data at baseline and their variation during the follow-up showed that lower basal gray matter atrophy was significantly related with higher progression of gray matter atrophy during follow-up. The correlation between MRI parameters and disease duration showed that gray matter atrophy rate decreased with increasing disease duration, whereas the rate of white matter atrophy had a constant pattern. Lower basal gray matter atrophy was associated with increased probability of developing gray matter atrophy at follow-up, whereas gray matter atrophy progression over 2 years and new T2 lesion load were risk factors for whole brain atrophy progression.
  
  
  CONCLUSIONS
  In MS, brain atrophy occurs even after a relatively short period of time and in patients with limited progression of disability. Short-term brain atrophy progression rates differ across tissue compartments, as gray matter atrophy results more pronounced than white matter atrophy and appears to be a early phenomenon in the MS-related disease progression.
authors.affiliation: Department of Neurological Sciences, Second University of Naples, Naples, Italy. gioacchino.tedeschi@unina2.it
authors.forename: G
authors.initials: G
authors.lastname: Tedeschi
authors.forename: D
authors.initials: D
authors.lastname: Dinacci
authors.forename: M
authors.initials: M
authors.lastname: Comerci
authors.forename: L
authors.initials: L
authors.lastname: Lavorgna
authors.forename: G
authors.initials: G
authors.lastname: Savettieri
authors.forename: A
authors.initials: A
authors.lastname: Quattrone
authors.forename: P
authors.initials: P
authors.lastname: Livrea
authors.forename: F
authors.initials: F
authors.lastname: Patti
authors.forename: V Brescia
authors.initials: VB
authors.lastname: Morra
authors.forename: G
authors.initials: G
authors.lastname: Servillo
authors.forename: G
authors.initials: G
authors.lastname: Orefice
authors.forename: M
authors.initials: M
authors.lastname: Paciello
authors.forename: A
authors.initials: A
authors.lastname: Prinster
authors.forename: G
authors.initials: G
authors.lastname: Coniglio
authors.forename: S
authors.initials: S
authors.lastname: Bonavita
authors.forename: A
authors.initials: A
authors.lastname: Di Costanzo
authors.forename: A
authors.initials: A
authors.lastname: Bellacosa
authors.forename: P
authors.initials: P
authors.lastname: Valentino
authors.forename: M
authors.initials: M
authors.lastname: Quarantelli
authors.forename: A
authors.initials: A
authors.lastname: Brunetti
authors.forename: G
authors.initials: G
authors.lastname: Salemi
authors.forename: M
authors.initials: M
authors.lastname: D'Amelio
authors.forename: I
authors.initials: I
authors.lastname: Simone
authors.forename: M
authors.initials: M
authors.lastname: Salvatore
authors.forename: V
authors.initials: V
authors.lastname: Bonavita
authors.forename: B
authors.initials: B
authors.lastname: Alfano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000453:epidemiology / Q000473:pathology*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000453:epidemiology / Q000473:pathology*; D015999:Multivariate Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult