title: Spatiotemporal distribution of white matter lesions in relapsing-remitting and secondary progressive multiple sclerosis.
abstract: BACKGROUND
  Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. MS lesions show a typical distribution pattern and primarily affect the white matter (WM) in the periventricular zone and in the centrum semiovale.
  
  
  OBJECTIVE
  To track lesion development during disease progression, we compared the spatiotemporal distribution patterns of lesions in relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS).
  
  
  METHODS
  We used T1 and T2 weighted MR images of 209 RRMS and 62 SPMS patients acquired on two different 1.5 Tesla MR scanners in two clinical centers followed up for 25 (± 1.7) months. Both cross-sectional and longitudinal differences in lesion distribution between RRMS and SPMS patients were analyzed with lesion probability maps (LPMs) and permutation-based inference.
  
  
  RESULTS
  MS lesions clustered around the lateral ventricles and in the centrum semiovale. Cross-sectionally, compared to RRMS patients, the SPMS patients showed a significantly higher regional probability of T1 hypointense lesions (p ≤ 0.03) in the callosal body, the corticospinal tract, and other tracts adjacent to the lateral ventricles, but not of T2 lesions (peak probabilities were RRMS: T1 9%, T2 18%; SPMS: T1 21%, T2 27%). No longitudinal changes of regional T1 and T2 lesion volumes between baseline and follow-up scan were found.
  
  
  CONCLUSIONS
  The results suggest a particular vulnerability to neurodegeneration during disease progression in a number of WM tracts.
authors.affiliation: Medical Image Analysis Center, University Hospital Basel, Basel, Switzerland.
authors.forename: Lukas
authors.initials: L
authors.lastname: Filli
authors.forename: Louis
authors.initials: L
authors.lastname: Hofstetter
authors.forename: Pascal
authors.initials: P
authors.lastname: Kuster
authors.forename: Stefan
authors.initials: S
authors.lastname: Traud
authors.forename: Nicole
authors.initials: N
authors.lastname: Mueller-Lenke
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Naegelin
authors.forename: Ludwig
authors.initials: L
authors.lastname: Kappos
authors.forename: Achim
authors.initials: A
authors.lastname: Gass
authors.forename: Till
authors.initials: T
authors.lastname: Sprenger
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Nichols
authors.forename: Hugo
authors.initials: H
authors.lastname: Vrenken
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
authors.forename: Chris
authors.initials: C
authors.lastname: Polman
authors.forename: Ernst-Wilhelm
authors.initials: EW
authors.lastname: Radue
authors.forename: Stefan J
authors.initials: SJ
authors.lastname: Borgwardt
authors.forename: Kerstin
authors.initials: K
authors.lastname: Bendfeldt
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001921:Brain / Q000473:pathology*; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D018450:Disease Progression; D005060:Europe; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000473:pathology*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000473:pathology*; D011237:Predictive Value of Tests; D013997:Time Factors