What is it about?
It is not established what are cut-off values of pathological global and regional brain atrophy in multiple sclerosis. To establish pathological cut-ofss is very important. Because, clinician needs to know, if individual patient has normal or abnormal brain atrophy. In other words, if disease is stable or is progressing. In this study we investigated 386 CIS, 964 RR MS, 63 secondary-progressive MS patients and 58 healthy controls. A total of 11,438 MRI scans were analysed using SIENA, SIENAX, FreeSurfer and ScanView software.
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Why is it important?
At a predefined specificity of 90% pathological cut-offs are following: - whole brain volume loss is: -0.40% per year - corpus callosum volume loss is: -0.57% per year - gray matter volume loss is: -0.53% per year - thalamic volume loss is: -0.64% per year Importantly, these pathological cut-offs are associated with greater increase of disability over time (=are clinically relevant)
Perspectives
Future studies need to replicate our results on largerr samples of healthy controls and using different volumetric software. Most important limitation for using defined cut-offs in routine clinical practice is a great individual variability of volumetric measures over time. This needs to be resolved in future research.
Dr. Tomas TU Uher
Charles University in Prague
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This page is a summary of: Pathological cut-offs of global and regional brain volume loss in multiple sclerosis, Multiple Sclerosis Journal, November 2017, SAGE Publications,
DOI: 10.1177/1352458517742739.
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