We investigated the evolution of cortical atrophy in patients with early relapsing-remitting (RR) multiple sclerosis (MS) and its association with lesion volume (LV) accumulation and disability progression. 136 of 181 RRMS patients who participated in the Avonex-Steroids-Azathioprine study were assessed bimonthly for clinical and MRI outcomes over 2 years. MS patients with disease duration (DD) at baseline of ≤24 months were classified in the early group (DD of 1.2 years, n=37 ), while patients with DD > 24 months were classified in the late group (DD of 7.1 years, n=99 ). Mixed effect model analysis was used to investigate the associations. Significant changes in whole brain volume (WBV) ( P<0.001 ), cortical volume (CV) ( P<0.001 ), and in T2-LV ( P<0.001 ) were detected. No significant MRI percent change differences were detected between early and late DD groups over 2 years, except for increased T2-LV accumulation between baseline and year 2 in the early DD group ( P<0.01 ). No significant associations were found between changes in T2-LV and CV over the followup. Change in CV was related to the disability progression over the 2 years, after adjusting for DD ( P=0.01 ). Significant cortical atrophy, independent of T2-LV accumulation, occurs in early RRMS over 2 years, and it is associated with the disability progression.
Zivadinov, R., Tekwe, C., Bergsland, N., Dolezal, O., Havrdova, E., Krasensky, J., … Horakova, D. (2013). Bimonthly Evolution of Cortical Atrophy in Early Relapsing-Remitting Multiple Sclerosis over 2 Years: A Longitudinal Study. Multiple Sclerosis International, 2013, 1–8. https://doi.org/10.1155/2013/231345