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Clinical impact of early brain atrophy in clinically isolated syndromes

2013; SAGE Publishing; Volume: 19; Issue: 14 Linguagem: Inglês

10.1177/1352458513488231

1477-0970

Francisco Pérez‐Miralles, Jaume Sastre‐Garriga, Mar Tintoré, Georgina Arrambide, Carlos Nos, Héctor Perkal, Jordi Río, M M Edo, Alejandro Horga, Joaquín Castilló, Cristina Auger, Elena Charro Huerga, Àlex Rovira, Xavier Montalbán,

Systemic Lupus Erythematosus Research

The impact of global and tissue-specific brain atrophy on conversion to multiple sclerosis (MS) after a clinically isolated syndrome (CIS) is not fully gauged.We aimed to determine the magnitude and clinical relevance of brain volume dynamics in the first year after a CIS.We assessed 176 patients with CIS within 3 months of onset, clinically and by conventional magnetic resonance imaging (MRI) scans, at baseline and 1 year after clinical onset. We determined the percentage of brain volume change (PBVC) and the brain parenchymal (BPF), grey matter (GMF) and white matter (WMF) fractions.The mean follow-up time was 53 months (SD = 16.8): 76 patients (43%) experienced a second attack, 32 (18%) fulfilled MRI-only 2005 McDonald criteria and 68 (39%) remained as CIS. Statistically significant decreases in the volume measures tested were observed in patients with a second attack, for BPF and PBVC; in both MS groups for GMF; whereas in all groups, the WMF was unchanged. Patients with a second attack had larger PBVC decreases (- 0.65% versus + 0.059%; p < 0.001). PBVC decreases below - 0.817% independently predicted shorter times to a second attack.Global brain and grey matter volume loss occurred within the first year after a CIS; brain volume loss predicted conversion to MS.