Brain volume loss in Japanese patients with multiple sclerosis is present in the early to middle stage of the disease

Abstract

BackgroundTo determine which disease-modifying therapies should be used in patients with multiple sclerosis (MS), identifying patients at high and low risk for brain volume loss (BVL) is important. Although the BVL rate in MS is nearly constant from early to late disease onset, regardless of the disease stage, individual differences have been noted. Moreover, as disease duration increases, the risk of chronic progression increases, and brain atrophy becomes more noticeable. Therefore, measuring prognosis using a classification that considers BVL rate and disease duration is appropriate. We aimed to investigate the BVL in Japanese patients with MS. MethodsHerein, with an observational period of approximately 3.5 years, 82 Japanese patients with MS were included. The volumes and annualised volume changes (AVCs) of the grey matter (GM) and whole brain were evaluated using icobrain ms. ResultsWhole-brain AVCs varied, especially among patients with a disease duration within approximately 16 years. Cluster analysis using two variables, disease duration and whole-brain AVC, identified the SM (short to middle duration and mild atrophy rates), SS (short to middle duration and severe atrophy rates), and L (long duration) groups. The optimal cut-off values for disease duration and whole-brain AVC to discriminate among the three groups were 15.8 years and −0.43%, respectively. Compared with the SM group, the SS group had higher Multiple Sclerosis Severity Scale (MSSS) and Expanded Disability Status Scale (EDSS) scores, lower information processing speed (IPS), higher lesion loads, higher whole-brain and GM volume loss, and higher GM atrophy rates. Moreover, among the 63 patients with MS included in the SM and SS groups, whole-brain AVCs were significantly correlated with the EDSS and MSSS scores and IPS. ConclusionBVL rates vary, especially among Japanese patients with MS with short to middle disease duration, and BVL degree is associated with poor prognosis.