Whole-brain atrophy: ready for implementation into clinical decision-making in multiple sclerosis?. Issue 3 (June 2016)

• Record Type: Journal Article
• Authors: Azevedo, Christina J.; Pelletier, Daniel
• Is Part Of: Current opinion in neurology. Volume 29:Issue 3(2016:Jun.)
• Publication Date: 2016-06
• Subjects: brain atrophy -- MRI -- multiple sclerosis -- neuroimaging; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.805
• DOI: 10.1097/WCO.0000000000000322
• Languages: English
• ISSNs: 1473-6551

Abstract

Abstract : Purpose of review: The article provides an overview of the importance of whole-brain atrophy in multiple sclerosis (MS) and proposes steps that would be necessary prior to incorporating whole-brain volume measurements into routine clinical practice. Recent findings: Whole-brain atrophy is clinically relevant, present early in the disease, and measureable in a reproducible manner using MRI. Several of the currently available approved disease-modifying therapies can slow the rate of whole-brain atrophy at the group level. As such, clinicians may want to use whole-brain volume measurements for clinical decision-making. Summary: Despite its relevance and face validity, several steps must be taken before whole-brain volume measurements are ready to be incorporated into clinical practice, including the adoption of a standardized MRI protocol for MS, the establishment of a gold-standard image postprocessing software to measure whole-brain volume, and the development of specific statistical methods to translate whole-brain volume measurements into clinically relevant metrics at the individual level. As neurodegeneration becomes the focus of MS research worldwide and the likely target of the next generation of disease-modifying therapies, MRI metrics associated with neurodegeneration will be critically important to monitor disease progression and treatment response at the group and individual levels.