MAGNIMS Consensus Recommendations on the Use of Brain and Spinal Cord Atrophy Measures in Clinical Practice

Overview

Journal Nat Rev Neurol

Specialty Neurology

Date 2020 Feb 26

PMID 32094485

Citations 95

Authors

Jaume Sastre-Garriga

Deborah Pareto

Marco Battaglini

Maria A Rocca

Olga Ciccarelli

Christian Enzinger

Jens Wuerfel

Maria P Sormani

Frederik Barkhof

Tarek A Yousry

Nicola De Stefano

Mar Tintore

Massimo Filippi

Claudio Gasperini

Ludwig Kappos

Jordi Rio

Jette Frederiksen

Jackie Palace

Hugo Vrenken

Xavier Montalban

Alex Rovira

Affiliations

Soon will be listed here.

Abstract

Early evaluation of treatment response and prediction of disease evolution are key issues in the management of people with multiple sclerosis (MS). In the past 20 years, MRI has become the most useful paraclinical tool in both situations and is used clinically to assess the inflammatory component of the disease, particularly the presence and evolution of focal lesions - the pathological hallmark of MS. However, diffuse neurodegenerative processes that are at least partly independent of inflammatory mechanisms can develop early in people with MS and are closely related to disability. The effects of these neurodegenerative processes at a macroscopic level can be quantified by estimation of brain and spinal cord atrophy with MRI. MRI measurements of atrophy in MS have also been proposed as a complementary approach to lesion assessment to facilitate the prediction of clinical outcomes and to assess treatment responses. In this Consensus statement, the Magnetic Resonance Imaging in MS (MAGNIMS) study group critically review the application of brain and spinal cord atrophy in clinical practice in the management of MS, considering the role of atrophy measures in prognosis and treatment monitoring and the barriers to clinical use of these measures. On the basis of this review, the group makes consensus statements and recommendations for future research.

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