title: Rate of brain atrophy in benign vs early multiple sclerosis.
abstract: BACKGROUND
  Benign multiple sclerosis (MS) is defined by minimal or no disability after many years of observation, therefore a less degenerative disease process is suspected to be present in this subset of patients.
  
  
  OBJECTIVE
  To compare brain atrophy rates in patients with long-standing benign MS vs typical early MS.
  
  
  METHODS
  A longitudinal prospective cohort study and a retrospective database review.
  
  
  METHODS
  An academic MS center.
  
  
  METHODS
  Thirty-nine patients with clinically defined benign MS and an age-matched group of 40 patients with early relapsing-remitting MS.
  
  
  METHODS
  Baseline demographic, treatment, brain magnetic resonance imaging measures, and annualized atrophy rates, derived from serial brain parenchymal fraction measurements across 2 years, were compared.
  
  
  RESULTS
  In the baseline analysis, patients with benign MS were matched to the early MS group on age, sex, treatment with immunomodulatory therapy, T2 lesion volume, and brain parenchymal fraction. The mean (SD) annualized brain atrophy rate in patients with benign MS (-0.16% [0.51%]) was lower than that in patients with early MS (-0.46% [0.72%]) (P = .02). The difference remained significant after controlling for age, sex, and treatment (P = .04).
  
  
  CONCLUSIONS
  Serial magnetic resonance imaging revealed a low 2-year rate of brain atrophy in patients with clinically benign MS, suggesting a less prominent degenerative component in its pathogenesis than in patients with typical early MS. Identification of patients with a low rate of brain atrophy may indicate a benign course.
authors.affiliation: Department of Neurology, Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. sag2015@med.cornell.edu
authors.forename: Susan A
authors.initials: SA
authors.lastname: Gauthier
authors.forename: Annika M
authors.initials: AM
authors.lastname: Berger
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Liptak
authors.forename: Yang
authors.initials: Y
authors.lastname: Duan
authors.forename: Svetlana
authors.initials: S
authors.lastname: Egorova
authors.forename: Guy J
authors.initials: GJ
authors.lastname: Buckle
authors.forename: Bonnie I
authors.initials: BI
authors.lastname: Glanz
authors.forename: Samia J
authors.initials: SJ
authors.lastname: Khoury
authors.forename: Rohit
authors.initials: R
authors.lastname: Bakshi
authors.forename: Howard L
authors.initials: HL
authors.lastname: Weiner
authors.forename: Charles R G
authors.initials: CR
authors.lastname: Guttmann
mesh_terms: D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D001284:Atrophy / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000145:classification / Q000473:pathology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index