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Erschienen in: CNS Drugs 2/2014

01.02.2014 | Review Article

Clinical Relevance of Brain Volume Measures in Multiple Sclerosis

verfasst von: Nicola De Stefano, Laura Airas, Nikolaos Grigoriadis, Heinrich P. Mattle, Jonathan O’Riordan, Celia Oreja-Guevara, Finn Sellebjerg, Bruno Stankoff, Agata Walczak, Heinz Wiendl, Bernd C. Kieseier

Erschienen in: CNS Drugs | Ausgabe 2/2014

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Abstract

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.
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Metadaten
Titel
Clinical Relevance of Brain Volume Measures in Multiple Sclerosis
verfasst von
Nicola De Stefano
Laura Airas
Nikolaos Grigoriadis
Heinrich P. Mattle
Jonathan O’Riordan
Celia Oreja-Guevara
Finn Sellebjerg
Bruno Stankoff
Agata Walczak
Heinz Wiendl
Bernd C. Kieseier
Publikationsdatum
01.02.2014
Verlag
Springer International Publishing
Erschienen in
CNS Drugs / Ausgabe 2/2014
Print ISSN: 1172-7047
Elektronische ISSN: 1179-1934
DOI
https://doi.org/10.1007/s40263-014-0140-z

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