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Clinical relevance of brain volume measures in multiple sclerosis

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  1. Pathophysiological Mechanisms in Migraine and the Identification of New Therapeutic Targets

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  2. Assessment of Opicinumab in Acute Optic Neuritis Using Multifocal Visual Evoked Potential

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  3. The Safety of Second-Generation Antipsychotics During Pregnancy: A Clinically Focused Review

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  4. Monoclonal Antibodies for Relapsing Multiple Sclerosis: A Review of Recently Marketed and Late-Stage Agents

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  5. Pharmacokinetic Variability of Drugs Used for Prophylactic Treatment of Migraine

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  1. Diagnostic Value of Oligoclonal Bands in Children: A Nationwide Population-Based Cohort Study

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  2. Smoking is associated with increased disease activity during natalizumab treatment in multiple sclerosis

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Functional neuroimaging of recovery from motor conversion disorder: A case report

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  4. Structural and cognitive correlates of fatigue in progressive multiple sclerosis

    Research output: Contribution to journalJournal articleResearchpeer-review

  • 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
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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.

Original languageEnglish
JournalC N S Drugs
Volume28
Issue number2
Pages (from-to)147-56
Number of pages10
ISSN1172-7047
DOIs
Publication statusPublished - Feb 2014

    Research areas

  • Adjuvants, Immunologic, Atrophy, Brain, Clinical Trials as Topic, Cognition Disorders, Cross-Sectional Studies, Disability Evaluation, Disease Progression, Humans, Magnetic Resonance Imaging, Multiple Sclerosis, Organ Size, Sensitivity and Specificity

ID: 44921370