Determinants of cerebral atrophy rate at the time of diagnosis of multiple sclerosis

Objective: To identify determinants visible on magnetic resonance imaging of the brain that explain the subsequent rate of cerebral atrophy in patients with recently diagnosed multiple sclerosis. Design: Magnetic resonance imaging of the brain was performed at baseline and after 2 years. T2 hyperintense lesion load, black hole lesion load, presence of contrast-enhancing lesions, and normalized brain volume were derived from the baseline magnetic resonance imaging and considered as possible explanatory variables for the subsequent annualized percentage of brain volume change (PBVC/y) using forward stepwise multiple linear regression analysis. Setting: MS center Amsterdam, Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands. Patients: Eighty-nine patients recently diagnosed as having multiple sclerosis were included at the time of diagnosis from our outpatient clinic. Main Outcome Measure: Annualized percentage of brain volume change. Results: The mean (SD) annualized rate of cerebral atrophy was -0.9 (0.8) PBVC/y. Baseline normalized brain volume (standardized coefficient, 0.426; P=.001) and baseline T2 lesion load (standardized coefficient, -0.244; P=.02) were identified as explanatory variables for subsequent PBVC/y and yielded a regression model that explained 31.2% of the variance in PBVC/y. Conclusions: In patients with recently diagnosed multiple sclerosis, the extent of accumulated brain tissue loss and overall lesion load partly explain the subsequent rate of cerebral atrophy.