Pathological cut-offs of global and regional brain volume loss in multiple sclerosis

Mult Scler. 2019 Apr;25(4):541-553. doi: 10.1177/1352458517742739. Epub 2017 Nov 16.


Background: Volumetric MRI surrogate markers of disease progression are lacking.

Objective: To establish cut-off values of brain volume loss able to discriminate between healthy controls and MS patients.

Methods: In total, 386 patients after first demyelinating event suggestive of MS (CIS), 964 relapsing-remitting MS (RRMS) patients, 63 secondary-progressive MS (SPMS) patients and 58 healthy controls were included in this longitudinal study. A total of 11,438 MRI scans performed on the same MRI scanner with the same protocol were analysed. Annualised percentage changes of whole brain, grey matter, thalamus and corpus callosum volumes were estimated. We investigated cut-offs able to discriminate between healthy controls and MS patients.

Results: At a predefined specificity of 90%, the annualised percentage change cut-off of corpus callosum volume (-0.57%) was able to distinguish between healthy controls and patients with the highest sensitivity (51% in CIS, 48% in RRMS and 42% in SPMS patients). Lower sensitivities (22%-49%) were found for cut-offs of whole brain, grey matter and thalamic volume loss. Among CIS and RRMS patients, cut-offs were associated with greater accumulation of disability.

Conclusion: We identified cut-offs of annualised global and regional brain volume loss rates able to discriminate between healthy controls and MS patients.

Keywords: MRI; Multiple sclerosis; brain atrophy; cut-off value; disability.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Atrophy / pathology
  • Brain / diagnostic imaging
  • Brain / pathology*
  • Corpus Callosum / diagnostic imaging
  • Corpus Callosum / pathology
  • Disease Progression*
  • Female
  • Gray Matter / diagnostic imaging
  • Gray Matter / pathology
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging / standards
  • Male
  • Middle Aged
  • Multiple Sclerosis / diagnosis*
  • Multiple Sclerosis / diagnostic imaging
  • Multiple Sclerosis / pathology*
  • Sensitivity and Specificity
  • Thalamus / diagnostic imaging
  • Thalamus / pathology
  • Young Adult