Andravizou Athina, Dardiotis Efthimios, Artemiadis Artemios, Sokratous Maria, Siokas Vasileios, Tsouris Zisis, Aloizou Athina-Maria, Nikolaidis Ioannis, Bakirtzis Christos, Tsivgoulis Georgios, Deretzi Georgia, Grigoriadis Nikolaos, Bogdanos Dimitrios P, Hadjigeorgiou Georgios M
1Department of Neurology, Laboratory of Neurogenetics, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, Biopolis, Mezourlo Hill, 41100 Larissa, Greece.
2Immunogenetics Laboratory, 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Aeginition Hospital, Vas. Sophias Ave 72-74, 11528 Athens, Greece.
Auto Immun Highlights. 2019 Aug 10;10(1):7. doi: 10.1186/s13317-019-0117-5. eCollection 2019 Dec.
Multiple sclerosis (MS) is an immune-mediated disease of the central nervous system characterized by focal or diffuse inflammation, demyelination, axonal loss and neurodegeneration. Brain atrophy can be seen in the earliest stages of MS, progresses faster compared to healthy adults, and is a reliable predictor of future physical and cognitive disability. In addition, it is widely accepted to be a valid, sensitive and reproducible measure of neurodegeneration in MS. Reducing the rate of brain atrophy has only recently been incorporated as a critical endpoint into the clinical trials of new or emerging disease modifying drugs (DMDs) in MS. With the advent of easily accessible neuroimaging softwares along with the accumulating evidence, clinicians may be able to use brain atrophy measures in their everyday clinical practice to monitor disease course and response to DMDs. In this review, we will describe the different mechanisms contributing to brain atrophy, their clinical relevance on disease presentation and course and the effect of current or emergent DMDs on brain atrophy and neuroprotection.
多发性硬化症（MS）是一种中枢神经系统的免疫介导性疾病，其特征为局灶性或弥漫性炎症、脱髓鞘、轴突损失和神经退行性变。脑萎缩在MS的最早阶段即可出现，与健康成年人相比进展更快，并且是未来身体和认知残疾的可靠预测指标。此外，它被广泛认为是MS中神经退行性变的一种有效、敏感且可重复的测量方法。降低脑萎缩率直到最近才被纳入MS新型或新兴疾病修饰药物（DMDs）临床试验的关键终点。随着易于获取的神经影像软件的出现以及证据的积累，临床医生或许能够在日常临床实践中使用脑萎缩测量方法来监测疾病进程以及对DMDs的反应。在本综述中，我们将描述导致脑萎缩的不同机制、它们在疾病表现和进程方面的临床相关性，以及当前或新兴DMDs对脑萎缩和神经保护的影响。
