Maria A Rocca1, Paolo Preziosa1, Sarlota Mesaros1, Elisabetta Pagani1, Jelena Dackovic1, Tatjana Stosic-Opincal1, Jelena Drulovic1, Massimo Filippi1. 1. From the Neuroimaging Research Unit (M.A.R., P.P., E.P., M.F.) and Department of Neurology (M.A.R., P.P.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy; and Clinics of Neurology (S.M., J. Dackovic, J. Drulovic) and Radiology (T.S.O.), Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Abstract
PURPOSE: To investigate the patterns of regional gray matter (GM) and white matter (WM) atrophy, WM microstructural tissue damage, and changes in patients with a clinically isolated syndrome (CIS) suggestive of multiple sclerosis at 2 years from clinical onset. MATERIALS AND METHODS: Institutional review board approval and written informed consent from all patients were obtained. Neurologic assessment and conventional, diffusion-tensor, and volumetric brain MR imaging sequences were performed in 37 patients with CIS within 2 months of clinical onset, and after 3, 12, and 24 months. Fourteen healthy control subjects also were studied. Longitudinal GM and WM volume changes and WM microstructural abnormalities were assessed by using voxel-based morphometry (P < .001, uncorrected) and tract-based spatial statistics (P < .05, corrected). RESULTS: At 24 months, 33 of 37 (89%) patients had developed multiple sclerosis. At month 3, patients with CIS showed a transient volume increase in frontal, parietal, temporal, and cerebellar GM regions. At 12 months, patients with CIS developed atrophy of the thalami, caudate nuclei, cerebellum, and frontal, parietal, and temporal lobes. At 24 months GM volume of the frontal, temporal, and parietal cortical areas further decreased from that at 12 months. WM atrophy involved only a few WM regions at 2 months from clinical onset, with progressive involvement of additional WM tracts with time. A diffuse pattern of WM microstructural abnormalities was detected within 2 months of onset and had worsened at 24 months. CONCLUSION: After an acute inflammatory event, dynamic modifications of regional GM and WM damage occur in patients with CIS, with a progressive evolution of WM damage from disease onset and a transient, early increase in GM volume, followed by GM atrophy. Neurodegenerative processes start early in patients with multiple sclerosis.
PURPOSE: To investigate the patterns of regional gray matter (GM) and white matter (WM) atrophy, WM microstructural tissue damage, and changes in patients with a clinically isolated syndrome (CIS) suggestive of multiple sclerosis at 2 years from clinical onset. MATERIALS AND METHODS: Institutional review board approval and written informed consent from all patients were obtained. Neurologic assessment and conventional, diffusion-tensor, and volumetric brain MR imaging sequences were performed in 37 patients with CIS within 2 months of clinical onset, and after 3, 12, and 24 months. Fourteen healthy control subjects also were studied. Longitudinal GM and WM volume changes and WM microstructural abnormalities were assessed by using voxel-based morphometry (P < .001, uncorrected) and tract-based spatial statistics (P < .05, corrected). RESULTS: At 24 months, 33 of 37 (89%) patients had developed multiple sclerosis. At month 3, patients with CIS showed a transient volume increase in frontal, parietal, temporal, and cerebellar GM regions. At 12 months, patients with CIS developed atrophy of the thalami, caudate nuclei, cerebellum, and frontal, parietal, and temporal lobes. At 24 months GM volume of the frontal, temporal, and parietal cortical areas further decreased from that at 12 months. WM atrophy involved only a few WM regions at 2 months from clinical onset, with progressive involvement of additional WM tracts with time. A diffuse pattern of WM microstructural abnormalities was detected within 2 months of onset and had worsened at 24 months. CONCLUSION: After an acute inflammatory event, dynamic modifications of regional GM and WM damage occur in patients with CIS, with a progressive evolution of WM damage from disease onset and a transient, early increase in GM volume, followed by GM atrophy. Neurodegenerative processes start early in patients with multiple sclerosis.
Authors: Maria A Rocca; Marco Battaglini; Ralph H B Benedict; Nicola De Stefano; Jeroen J G Geurts; Roland G Henry; Mark A Horsfield; Mark Jenkinson; Elisabetta Pagani; Massimo Filippi Journal: Neurology Date: 2016-12-16 Impact factor: 9.910
Authors: Paolo Preziosa; Elisabetta Pagani; Sarlota Mesaros; Gianna C Riccitelli; Jelena Dackovic; Jelena Drulovic; Massimo Filippi; Maria A Rocca Journal: Hum Brain Mapp Date: 2017-08-09 Impact factor: 5.038
Authors: Benjamin D S Clarkson; Ethan Grund; Kenneth David; Renee K Johnson; Charles L Howe Journal: J Neuroinflammation Date: 2022-10-20 Impact factor: 9.587
Authors: Andrés Labiano-Fontcuberta; Virginia Mato-Abad; Juan Álvarez-Linera; Juan Antonio Hernández-Tamames; María Luisa Martínez-Ginés; Yolanda Aladro; Lucía Ayuso; Ángela Domingo-Santos; Julián Benito-León Journal: Medicine (Baltimore) Date: 2016-07 Impact factor: 1.889
Authors: Andrés Labiano-Fontcuberta; Virginia Mato-Abad; Juan Álvarez-Linera; Juan Antonio Hernández-Tamames; M Luisa Martínez-Ginés; Yolanda Aladro; Lucía Ayuso; Ángela Domingo-Santos; Julián Benito-León Journal: Medicine (Baltimore) Date: 2016-03 Impact factor: 1.889