title: Clinical impact of early brain atrophy in clinically isolated syndromes.
abstract: BACKGROUND
  The impact of global and tissue-specific brain atrophy on conversion to multiple sclerosis (MS) after a clinically isolated syndrome (CIS) is not fully gauged.
  
  
  OBJECTIVE
  We aimed to determine the magnitude and clinical relevance of brain volume dynamics in the first year after a CIS.
  
  
  METHODS
  We assessed 176 patients with CIS within 3 months of onset, clinically and by conventional magnetic resonance imaging (MRI) scans, at baseline and 1 year after clinical onset. We determined the percentage of brain volume change (PBVC) and the brain parenchymal (BPF), grey matter (GMF) and white matter (WMF) fractions.
  
  
  RESULTS
  The mean follow-up time was 53 months (SD = 16.8): 76 patients (43%) experienced a second attack, 32 (18%) fulfilled MRI-only 2005 McDonald criteria and 68 (39%) remained as CIS. Statistically significant decreases in the volume measures tested were observed in patients with a second attack, for BPF and PBVC; in both MS groups for GMF; whereas in all groups, the WMF was unchanged. Patients with a second attack had larger PBVC decreases (- 0.65% versus + 0.059%; p < 0.001). PBVC decreases below - 0.817% independently predicted shorter times to a second attack.
  
  
  CONCLUSIONS
  Global brain and grey matter volume loss occurred within the first year after a CIS; brain volume loss predicted conversion to MS.
authors: Multiple Sclerosis Center of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors: F
authors: F
authors: Pérez-Miralles
authors: J
authors: J
authors: Sastre-Garriga
authors: M
authors: M
authors: Tintoré
authors: G
authors: G
authors: Arrambide
authors: C
authors: C
authors: Nos
authors: H
authors: H
authors: Perkal
authors: J
authors: J
authors: Río
authors: M C
authors: MC
authors: Edo
authors: A
authors: A
authors: Horga
authors: J
authors: J
authors: Castilló
authors: C
authors: C
authors: Auger
authors: E
authors: E
authors: Huerga
authors: A
authors: A
authors: Rovira
authors: X
authors: X
authors: Montalban
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001284:Atrophy; D001921:Brain / Q000187:drug effects / Q000473:pathology*; D003711:Demyelinating Diseases / Q000188:drug therapy / Q000473:pathology*; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000473:pathology*; D009929:Organ Size; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D007155:Immunologic Factors
keywords: Brain atrophy; brain volume; clinically isolated syndrome; disability; grey matter; magnetic resonance imaging; multiple sclerosis