Clinical Relevance of Brain Volume Measures in Multiple Sclerosis
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Clinical Relevance of Brain Volume Measures in Multiple Sclerosis. / De Stefano, Nicola; Airas, Laura; Grigoriadis, Nikolaos; Mattle, Heinrich P; O'Riordan, Jonathan; Oreja-Guevara, Celia; Sellebjerg, Finn; Stankoff, Bruno; Walczak, Agata; Wiendl, Heinz; Kieseier, Bernd C.
I: C N S Drugs, Bind 28, Nr. 2, 02.2014, s. 147-156.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Clinical Relevance of Brain Volume Measures in Multiple Sclerosis
AU - De Stefano, Nicola
AU - Airas, Laura
AU - Grigoriadis, Nikolaos
AU - Mattle, Heinrich P
AU - O'Riordan, Jonathan
AU - Oreja-Guevara, Celia
AU - Sellebjerg, Finn
AU - Stankoff, Bruno
AU - Walczak, Agata
AU - Wiendl, Heinz
AU - Kieseier, Bernd C
PY - 2014/2
Y1 - 2014/2
N2 - Multiple sclerosis (MS) is a chronic disease with an inflammatory and neurodegenerative pathology. Axonal loss and neurodegeneration occurs early in the disease course and may lead to irreversible neurological impairment. Changes in brain volume, observed from the earliest stage of MS and proceeding throughout the disease course, may be an accurate measure of neurodegeneration and tissue damage. There are a number of magnetic resonance imaging-based methods for determining global or regional brain volume, including cross-sectional (e.g. brain parenchymal fraction) and longitudinal techniques (e.g. SIENA [Structural Image Evaluation using Normalization of Atrophy]). Although these methods are sensitive and reproducible, caution must be exercised when interpreting brain volume data, as numerous factors (e.g. pseudoatrophy) may have a confounding effect on measurements, especially in a disease with complex pathological substrates such as MS. Brain volume loss has been correlated with disability progression and cognitive impairment in MS, with the loss of grey matter volume more closely correlated with clinical measures than loss of white matter volume. Preventing brain volume loss may therefore have important clinical implications affecting treatment decisions, with several clinical trials now demonstrating an effect of disease-modifying treatments (DMTs) on reducing brain volume loss. In clinical practice, it may therefore be important to consider the potential impact of a therapy on reducing the rate of brain volume loss. This article reviews the measurement of brain volume in clinical trials and practice, the effect of DMTs on brain volume change across trials and the clinical relevance of brain volume loss in MS.
AB - Multiple sclerosis (MS) is a chronic disease with an inflammatory and neurodegenerative pathology. Axonal loss and neurodegeneration occurs early in the disease course and may lead to irreversible neurological impairment. Changes in brain volume, observed from the earliest stage of MS and proceeding throughout the disease course, may be an accurate measure of neurodegeneration and tissue damage. There are a number of magnetic resonance imaging-based methods for determining global or regional brain volume, including cross-sectional (e.g. brain parenchymal fraction) and longitudinal techniques (e.g. SIENA [Structural Image Evaluation using Normalization of Atrophy]). Although these methods are sensitive and reproducible, caution must be exercised when interpreting brain volume data, as numerous factors (e.g. pseudoatrophy) may have a confounding effect on measurements, especially in a disease with complex pathological substrates such as MS. Brain volume loss has been correlated with disability progression and cognitive impairment in MS, with the loss of grey matter volume more closely correlated with clinical measures than loss of white matter volume. Preventing brain volume loss may therefore have important clinical implications affecting treatment decisions, with several clinical trials now demonstrating an effect of disease-modifying treatments (DMTs) on reducing brain volume loss. In clinical practice, it may therefore be important to consider the potential impact of a therapy on reducing the rate of brain volume loss. This article reviews the measurement of brain volume in clinical trials and practice, the effect of DMTs on brain volume change across trials and the clinical relevance of brain volume loss in MS.
KW - Adjuvants, Immunologic
KW - Atrophy
KW - Brain
KW - Clinical Trials as Topic
KW - Cognition Disorders
KW - Cross-Sectional Studies
KW - Disability Evaluation
KW - Disease Progression
KW - Humans
KW - Magnetic Resonance Imaging
KW - Multiple Sclerosis
KW - Organ Size
KW - Sensitivity and Specificity
U2 - 10.1007/s40263-014-0140-z
DO - 10.1007/s40263-014-0140-z
M3 - Journal article
C2 - 24446248
VL - 28
SP - 147
EP - 156
JO - CNS Drugs
JF - CNS Drugs
SN - 1172-7047
IS - 2
ER -
ID: 138147302