Determinants of Cerebral Atrophy Rate at the Time of Diagnosis of Multiple Sclerosis

Abstract

<h3>Objective</h3> To identify determinants visible on magnetic resonance imaging of the brain that explain the subsequent rate of cerebral atrophy in patients with recently diagnosed multiple sclerosis. <h3>Design</h3> Magnetic resonance imaging of the brain was performed at baseline and after 2 years. T2 hyperintense lesion load, black hole lesion load, presence of contrast-enhancing lesions, and normalized brain volume were derived from the baseline magnetic resonance imaging and considered as possible explanatory variables for the subsequent annualized percentage of brain volume change (PBVC/y) using forward stepwise multiple linear regression analysis. <h3>Setting</h3> MS center Amsterdam, Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands. <h3>Patients</h3> Eighty-nine patients recently diagnosed as having multiple sclerosis were included at the time of diagnosis from our outpatient clinic. <h3>Main Outcome Measure</h3> Annualized percentage of brain volume change. <h3>Results</h3> The mean (SD) annualized rate of cerebral atrophy was −0.9 (0.8) PBVC/y. Baseline normalized brain volume (standardized coefficient, 0.426;<i>P</i> = .001) and baseline T2 lesion load (standardized coefficient, −0.244;<i>P</i> = .02) were identified as explanatory variables for subsequent PBVC/y and yielded a regression model that explained 31.2% of the variance in PBVC/y. <h3>Conclusions</h3> In patients with recently diagnosed multiple sclerosis, the extent of accumulated brain tissue loss and overall lesion load partly explain the subsequent rate of cerebral atrophy.