Measuring brain shrinkage in Multiple Sclerosis

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MSUK
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Measuring brain shrinkage in Multiple Sclerosis

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Sub-Millimeter Imaging of Brain-Free Water for Rapid Volume Assessment in Atrophic Brains.

Gao KC, Nair G, Cortese IC, Koretsky A, Reich DS.

Abstract

INTRODUCTION: Cerebral atrophy occurs in healthy aging, and in disease processes such as multiple sclerosis (MS), it correlates with disability accumulation. Imaging measurements of brain atrophy are commonly based on tissue segmentation, which is susceptible to classification errors and inconsistencies. High-resolution imaging techniques with strong contrast between brain parenchyma and cerebrospinal fluid (CSF) might allow fully automated, rapid, threshold-based determination of the free water in the brain. We hypothesized that total brain-free-water (BFW) volume and BFW volume expressed as a normalized fraction of the intracranial volume ("BFW fraction"), determined from heavily T2-weighted images, would be useful surrogates for cerebral atrophy and therefore would correlate with clinical measures of disability in MS....... Read More - http://www.ms-uk.org/medicalimaging
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jackD
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Re: Measuring brain shrinkage in Multiple Sclerosis

Post by jackD »

What brain shrinkage???

The radiologist wrote on my MRI "Moderate brain shrinkage is noted, but appropriate for age and medical conditions."
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CaliReader
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Re: Measuring brain shrinkage in Multiple Sclerosis

Post by CaliReader »

Sadly, yes. MS causes brain atrophy at a faster than normal rate.

http://www.medscape.com/viewarticle/759837_3

Brain Atrophy in MS

Brain volume measurements are not used in routine clinical practice, but it is a very attractive MRI metric in MS because it is clinically relevant, robust and could offer an in vivo measure of neurodegeneration. In general, brain volume in MS patients decreases by 0.7–1.0% per year,[15] which is approximately three-times the rate of normal controls. It can be seen as early as CIS.[16,17] It has been shown to correlate with cognitive impairment,[18] EDSS[19] and quality of life.[20]

Overall, brain atrophy (pathological loss of tissue) represents the net effect of tissue damage in MS. The exact mechanism by which brain atrophy occurs remains incompletely understood. Axonal loss within white matter lesions probably contributes to brain atrophy by two mechanisms: the amount of tissue lost within the lesions themselves, and Wallerian degeneration in pathways related to the lesions.[15,21] Some studies have found a tight correlation between white matter lesion burden and brain volume;[22] however, other studies suggest that this correlation is only modest, suggesting that separate pathologic processes are also contributing to the loss of brain volume.[21] Gray matter lesions occur but may not be directly associated with cortical thinning; one pathologic study of 22 MS patients and 17 controls failed to find a significant correlation between gray matter lesions and cortical thinning.[23] Iron deposition may also potentially contribute to brain atrophy.[24]
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Re: Measuring brain shrinkage in Multiple Sclerosis

Post by NHE »

CaliReader wrote:Sadly, yes. MS causes brain atrophy at a faster than normal rate.
White matter atrophy is also associated with elevated homocysteine which is an indicator of vitamin B12 deficiency.

http://www.thisisms.com/forum/natural-a ... ml#p225969

In addition, B12 deficiency is also associated with periventricular white matter lesions.

http://www.thisisms.com/forum/natural-a ... ml#p226718

I think it's in every MS patient's best interest to get their B12 levels checked.
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Re: Measuring brain shrinkage in Multiple Sclerosis

Post by Kronk »

In relation to disability progression the research clearly points more to grey matter loss than to white matter lesions. The grey matter loss was originally identified by Jean Martin Charcot 140 years ago. The research to Grey matter loss in MS since is pitiful, and has almost exclusively focused on the white matter lesions. I found the study below very interesting which showed grey matter atrophy rates in various phases of MS vs. controls. RRMS 3.4x Grey Matter loss, SPMS 14x Grey Matter loss. The white matter atrophy rate was 3x controls across all MS disease stages. It seems clear what is driving the root of MS disability.

http://www.ncbi.nlm.nih.gov/pubmed/18661561
Grey matter atrophy in MS

http://www.ncbi.nlm.nih.gov/pubmed/18570297
Gray matter atrophy is related to long-term disability in multiple sclerosis.
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