Tuesday, 9 July 2013

Brain atrophy and memory impairment in MS

How important is the observation of brain atrophy in MS? #MSBlog #MSResearch

Epub: Deluca et al. Memory impairment in multiple sclerosis is due to a core deficit in initial learning. J Neurol. 2013 Jul 6.

Background: MSers suffer memory impairment, but research on the nature of MS-related memory problems is mixed. Some have argued for a core deficit in retrieval, while others have identified deficient initial learning as the core deficit. 

Methods: These investigators used a selective reminding paradigm to determine whether deficient initial learning or delayed retrieval represents the primary memory deficit in 44 persons with MS. Brain atrophy was measured from high-resolution MRIs. Regression analyses examined the impact of brain atrophy on (a) initial learning and delayed retrieval separately, and then (b) delayed retrieval controlling for initial learning. 

Results: Brain atrophy was negatively associated with both initial learning and delayed retrieval (ps < 0.01), but brain atrophy was unrelated to retrieval when controlling for initial learning (p > 0.05). In addition, brain atrophy was associated with inefficient learning across initial acquisition trials, and brain atrophy was unrelated to delayed recall among MS subjects who successfully acquired the word list (although such learning frequently required many exposures). 

Conclusions: Taken together, memory deficits in MS are a result of deficits in initial learning; moreover, initial learning mediates the relationship between brain atrophy and subsequent retrieval, thereby supporting the core learning-deficit hypothesis of memory impairment in MS.

"Brain atrophy is associated with cognitive impairment in MS and may be the major determinant of this problem. What can we do about it? The good news for RRMSers is that the highly effective DMTs have an impact on brain atrophy. This is why we need to get the MS community to start asking questions about brain atrophy."



05 Jul 2013
Rebranding MS a dementia (7): disease progression and brain atrophy. Progressive brain atrophy; should you accept it? #MSBlog #MSResearch. Epub: Hofstetter et al. Progression in disability and regional grey matter ...
28 May 2013
The only way we are going to get brain atrophy up the agenda is for you to ask your neurologist about whether or not you have evidence of brain atrophy on your MRI. Unless the atrophy is gross atrophy, i.e. visible to the ...
15 Apr 2013
Objective: Through a retrospective analysis, the objective of this study was to determine whether daclizumab treatment reduces the rate of brain structure atrophy in comparison to a mixture of other disease-modifying therapies ...
30 Mar 2013
Annualised whole brain atrophy, central brain atrophy rates and T2 lesion volumes were calculated. MSers were categorised by baseline diagnosis as primary progressive MS (n=77), clinically isolated syndromes (n=18), ...

31 Jan 2013
The first problem is that our neuroradiologists don't routinely report brain atrophy, unless it is gross atrophy, i.e. easy to see with the naked eye. Although we know that brain atrophy occurs early in the disease course it is often ...
15 Feb 2013
"This study confirms what we already know from several other studies that MS is associated with progressive brain atrophy that begins early in the disease and is associated with disability progression. This is why it is important ...
1 hour ago
Brain atrophy in benign MS. Another post in response to the question about benign MS. Gauthier et al. Rate of brain atrophy in benign vs early multiple sclerosis. Arch Neurol. 2009 Feb;66(2):234-7. BACKGROUND: Benign .
13 Jun 2013
Open Neurol J. 2013 May 3;7:11-6. OBJECTIVE: To estimate the quantity of multiple sclerosis (MS) patients with brain atrophy as indicated by third ventricular enlargement using transcranial colourcoded ultrasound (TCCS).

15 Jun 2013
"As you can see from the 4 studies below Alemtuzumab (aka Campath or Campath-1h) has a positive effect on brain atrophy, when compared to interferon-beta. It slows the rate of brain shrinkage. In addition it has a positive ...
06 Jul 2013
RESULTS: As expected, there were age- and sex- related changes with male and older cohorts showing worse disease severity (EDSS), brain atrophy (BPF), and more progressive course.There was no interaction between ...
18 May 2013
BACKGROUND: The impact of global and tissue-specific brain atrophy on conversion to MS after a clinically isolated syndrome (CIS) is not fully gauged. OBJECTIVES: These investigators' aimed to determine the magnitude ...
26 Nov 2012
I am therefore very impressed that 38% of readers of this blog rated brain atrophy as the most important outcome measure for a DMT. I am not sure in myself that it should be rated this highly at this point in time, simply because ...

17 Nov 2012
"Data from several emerging DMTs now supports the natural history studies and the observation that there is a disconnect between relapses and disease progression and importantly an impact on brain atrophy. We have ...
29 Nov 2011
RESULTS: The mean (SD) annualized brain atrophy rate in MS'ers with benign MS (-0.16% [0.51%]) was lower than that in patients with early MS (-0.46% [0.72%]) (P = .02). The difference remained significant after controlling ...
31 May 2012
BACKGROUND: Brain atrophy (shrinkage) is a well-accepted imaging biomarker of multiple sclerosis (MS) that partially correlates with both physical disability and cognitive impairment. METHODOLOGY/PRINCIPAL ...
01 Feb 2013
"What the serial MRIs on these MSers show is the extraordinary amount of brain atrophy that can occur over an 18 month period - look at the black spaces in the centre of the brain, the ventricles, and see how they enlarge ...

20 Mar 2012
Research: Brain Shrinkage. Riccitelli et al. Mapping regional grey and white matter atrophy in relapsing-remitting multiple sclerosis.Mult Scler. 2012 Mar 15. [Epub ahead of print] Objective: We aimed to investigate the regional ...
20 Oct 2012
Natalizumab may reduce cognitive changes and brain atrophy rate in relapsing-remitting multiple sclerosis: a prospective, non-randomized pilot study. Eur J Neurol. 2012 Oct 11. doi: 10.1111/j.1468-1331.2012.03882.x.
15 Apr 2013
OBJECTIVE: To test the cognitive reserve (CR) hypothesis in the model of multiple sclerosis (MS) by assessing the interactions among CR, brain atrophy, and cognitive efficiency in patients with relapsing-remitting MS.
09 Mar 2012
OBJECTIVE: To assess the evolution of brain atrophy and its relationship with inflammatory activity in RRMS patients treated with natalizumab. METHODS: Eighteen RRMS patients were prospectively followed up for 18 ...

06 Feb 2013
We performed a prospective cross-sectional study with a statistically pre-defined endpoint to test our hypothesis that OCT measures of neuro-axonal degeneration are related to global and partial brain atrophy in early forms of ...
21 Nov 2012
CONCLUSIONS: Neurological impairment is more permanent, brain atrophy is accelerated and focal inflammatory activity is greater in patients converting to clinically definite multiple sclerosis. Six-month corpus callosum ...
08 Jun 2013
Materials and Methods:Upper cervical cord cross-sectional area (UCCA), brain and spinal cord lesion loads, and brain atrophy were measured in 440 patients with MS (311 with relapsing-remitting [RR] MS, 92 with ...
17 Jun 2013
On MR scans, we found comparable levels of lesion loads and brain atrophy in subjects with RIS and well-established RRMS. In subjects with RIS, high T1 lesion volume (ρ = 0.526, p = 0.025) and low cortical volume (ρ ...

23 Nov 2012
BACKGROUND: Brain size, white matter hyperintensity, and the development of brain atrophy are known to be highly heritable. The decrease of brain volume starts from the very onset of MS and is 10-fold compared with ...
08 Jan 2012
In vivo scanning permitted us to evaluate brain structure volumes in individual animals over time and we observed that though brain atrophy progressed differently in each individual animal, all mice with EAE demonstrated ...
25 Jun 2013
Evidence for previous damage in MSers who are functioning normally can usually be detected with detailed cognitive assessments or using sensitive MRI outcomes for example brain atrophy." "Some of you are cynical about ...
18 Jun 2012
Methods: In 39 multiple sclerosis patients the area of corpus callosum in the sagittal plane, T(2) and T(1) lesion volumes, brain parenchymal fraction and brain atrophy were determined at baseline and 1 year after treatment ...

31 May 2013
VBM = voxel based morphometry morphs the brain onto a standard template and looks for subtle anatomical variations, for example shrinkage of the brain in a specific region. TBSS = tract-based spatial statistics is a measure ...
12 Jun 2013
"The sets of MRI studies below are from two MSers with RRMS who were followed for 18 months; please note the degree of brain atrophy that occurred during this period of time? A picture is worth a thousands words and ...
29 Jan 2013
Brain lesions in childhood MS are same as in adult onset MS. #MSBlog: Childhood and adult MS looks the same on MRI. Are you surprised? Donohue et al. No Regional Gray Matter Atrophy Differences between Pediatric- ...
20 Nov 2012
"This is one of many studies to show that subtle brain atrophy exists at the very earliest clinical stage of MS, i.e. at presentation with the first attack. Many, including myself, would therefore argue that neurodegeneration is ...

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