Clinical impact of early brain atrophy in clinically isolated syndromes

This study group investigated the short-term evolution of tissue-specific and global brain atrophy in people with clinically isolated syndrome (CIS), to define their separate clinical relevance in terms of mid-term disability, as well as conversion to MS. The study included 176 people with CIS within three months of onset, clinically and by conventional MRI scans at baseline and one year after clinical onset.

The scans were analysed to calculate the percentage of brain volume change (PBVC) and brain parenchymal (BPF), grey matter (GMF) and white matter fractions (WMF). 43% of participants had experienced a second attack, 18% fulfilled MRI-only 2005 McDonald criteria and 39% remained as CIS.

The finding from this study showed that brain volume loss was already detectable over the first year after a first demyelinating attack, and this was likely due to grey, but not white matter volume loss. This was more prominent in people with CIS who go on to develop MS. Also there was an association between very early atrophy development and disability changes in the first and second year after a CIS in those who later develop MS.

Authors: Pérez-Miralles F, Sastre-Garriga J

: Mult Scler 2013 May 7. [Epub ahead of print]

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