, Volume 52, Issue 2, pp 109–117 | Cite as

A longitudinal observational study of brain atrophy rate reflecting four decades of multiple sclerosis: a comparison of serial 1D, 2D, and volumetric measurements from MRI images

  • Juha MartolaEmail author
  • Jakob Bergström
  • Sten Fredrikson
  • Leszek Stawiarz
  • Jan Hillert
  • Yi Zhang
  • Olof Flodmark
  • Anders Lilja
  • Anders Ekbom
  • Peter Aspelin
  • Maria Kristoffersen Wiberg
Diagnostic Neuroradiology



Multiple sclerosis (MS) has a variable progression with an early onset of atrophy. Individual longitudinal radiological evaluations (over decades) are difficult to perform due to the limited availability of magnetic resonance imaging (MRI) in the past, patients lost in follow-up, and the continuous updating of scanners. We studied a cohort with widespread disease duration at baseline. The observed individual atrophy rates over time of 10 years represented four decades of disease span.


Thirty-seven MS patients (age range 24–65 years with disease duration 1–33 years) were consecutively selected and evaluated with MRI at baseline 1995 and in 1996. They were followed up for a decade (mean of 9.25 years, range 7.3–10 years) up to 2003–2005. Brain parenchymal volume and volumes of the supratentorial ventricles were analyzed with semi-automated volumetric measurements at three time points (1995, 1996, and 2003–2005).


Volumetric differences were found over shorter periods of time (1–7 months); however, differences vanished by the end of follow-up. A uniform longitudinal decrease in brain volume and increase in ventricle volumes were found. Frontal horn width (1D) correlated strongest to 3D measures. No statistical differences of atrophy rates between MS courses were found. Supratentorial ventricular volumes were associated with disability and this association persisted during follow-up.


Despite variable clinical courses, the degenerative effects of MS progression expressed in brain atrophy seem to uniformly progress over longer periods of time. These volumetric changes can be detected using 1D and 2D measurements performed on a routine PACS workstation.


MRI Multiple sclerosis Brain atrophy Disability 


Conflict of interest statement

We declare that we have no conflict of interest.


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Juha Martola
    • 1
    Email author
  • Jakob Bergström
    • 5
  • Sten Fredrikson
    • 3
  • Leszek Stawiarz
    • 3
  • Jan Hillert
    • 3
  • Yi Zhang
    • 1
  • Olof Flodmark
    • 2
  • Anders Lilja
    • 2
  • Anders Ekbom
    • 4
  • Peter Aspelin
    • 1
  • Maria Kristoffersen Wiberg
    • 1
  1. 1.Division of Radiology, Department of Clinical Science, Intervention, and TechnologyKarolinska InstitutetStockholmSweden
  2. 2.Department of Neuroradiology, Department of Clinical NeuroscienceKarolinska University HospitalStockholmSweden
  3. 3.Division of Neurology, Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
  4. 4.Clinical Epidemiology UnitKarolinska InstitutetStockholmSweden
  5. 5.The Medical Statistics Unit, Department of Learning, Informatics, Management & Ethics (LIME)Karolinska InstitutetStockholmSweden

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