Bermel Robert A, Bakshi Rohit
Department of Neurology, Cleveland Clinic Foundation, Cleveland, OH, USA.
Lancet Neurol. 2006 Feb;5(2):158-70. doi: 10.1016/S1474-4422(06)70349-0.
Brain atrophy has emerged as a clinically relevant component of disease progression in multiple sclerosis. Progressive loss of brain tissue bulk can be detected in vivo in a sensitive and reproducible manner by MRI. Clinical studies have shown that brain atrophy begins early in the disease course. The increasing amount of data linking brain atrophy to clinical impairments suggest that irreversible tissue destruction is an important determinant of disease progression to a greater extent than can be explained by conventional lesion assessments. In this review, we will summarise the proposed mechanisms contributing to brain atrophy in patients with multiple sclerosis. We will critically discuss the wide range of MRI-based methods used to quantify regional and whole-brain-volume loss. Based on a review of current information, we will summarise the rate of atrophy among phenotypes for multiple sclerosis, the clinical relevance of brain atrophy, and the effect of disease-modifying treatments on its progression.
脑萎缩已成为多发性硬化症疾病进展中一个具有临床相关性的组成部分。通过磁共振成像（MRI）能够以敏感且可重复的方式在体内检测到脑组织体积的逐渐减少。临床研究表明，脑萎缩在疾病进程早期就已开始。越来越多的数据将脑萎缩与临床损伤联系起来，这表明不可逆的组织破坏在疾病进展中是一个重要的决定因素，其程度超过了传统病灶评估所能解释的范围。在本综述中，我们将总结多发性硬化症患者脑萎缩的潜在机制。我们将批判性地讨论用于量化局部和全脑体积损失的多种基于MRI的方法。基于对当前信息的综述，我们将总结多发性硬化症各表型的萎缩率、脑萎缩的临床相关性以及疾病修饰治疗对其进展的影响。
