A longitudinal study of ventricular volume in early relapsing-remining multiple sclerosis

The specific aim of this study was to determine whether Progressive brain a trophy could be detected within 18 months of establishing a diagnosis of re lapsing-remitting multiple sclerosis (RRMS). Fifteen patients with clinical ly definite RRMS (mean disease duration from first symptom=6 months, mean E DSS=1.2) completed 6-14 monthly quantitative MRI sessions. The volume of th e lateral ventricles was determined each month using a semi-automated thres holding technique from TI-weighted axial images. The number of new monthly gadolinium-enhancing (Gd+) lesions and EDSS scores were also recorded. Late ral ventricular volumes increased significantly during this study. When ind ividual data were examined, statistically significant changes were observed in six of 15 patients. Monthly change in ventricular volume was related to baseline EDSS and total number of new Gd+ lesions. These observations indi cate brain atrophy, a putative imaging marker of diffuse demyelination and axonal toss, can occur as early as 18 months after first symptoms of RRMS, and is related to the baseline level of disability and to the number of new Gd+ lesions.