The correlation between ventricular diameter measured by transcranial sonography and clinical disability and cognitive dysfunction in patients with multiple sclerosis

Context: Magnetic resonance imaging. (MRI) data suggest that the extent of brain atrophy in patients with multiple sclerosis (MS) is related to the se verity of disease. Objective: To evaluate whether ventricular diameter determined by transcran ial sonography (TCS) is a marker of brain atrophy and is correlated with di sability, cognitive performance, and mood. Subjects and Methods: We examined 74 subjects with MS and 74 age- and sex-m atched control subjects with TCS and assessed the transverse diameter of th e third ventricle and the Frontal horns of the lateral ventricles. Quantita tive neurological examination was performed in subjects with MS using the E xpanded Disability Status Scale. All subjects with MS underwent MRI, the Br ief Repeatable Battery of Neuropsychological Tests for MS, and standardized tests For mood disorders. Results: Transcranial sonographic measurements of ventricular diameter clos ely matched MRI measurements (Spearman rank correlation, r = 0.7-0.9; P<.01 ). The ventricular diameters were significantly larger in subjects with MS than in healthy age- and sex-matched control subjects. The measurement of t he diameter of the third ventricle obtained by TCS or MRI and the measureme nt of disability obtained with the Expanded Disability Status Scale were si gnificantly correlated (Spearman rank correlation, r=0.4; P<.01). The corre lation between the diameter of the frontal horns and disability was substan tially lower for both neuroimaging techniques. In addition, TCS and MRI dat a correlated significantly with the majority of neuropsychological tests; n o correlation was found between the diameter of the ventricles and depressi on scales. Conclusion: As ventricular diameter is related to the status of disability and may also indicate disease progression, we propose measurement of the di ameter of the third ventricle with TCS as a quid; and easy surrogate marker for serial follow-up examinations in patients with MS.