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Pseudoatrophy of the brain in multiple sclerosis : the effect of therapy on T1 measures of brain water content Mackie, Emilie Ceschi


Magnetic Resonance Imaging (MRI) measures of T₁ relaxation provide a sensitive and reproducible measure of water content in vivo. In the present study T₁ histograms were used to monitor changes in the brain water content of multiple sclerosis (MS) patients initiating Disease Modifying Therapies (DMT). The initiation of DMT, which target inflammation, is associated with a decrease in brain volume (BV) greater than would be expected by natural history alone. Reductions in BV may reflect worsening disease in untreated patients; however for patients treated with DMT, reductions in BV early in the treatment course may represent a clinical improvement due to initial anti-inflammatory effects of therapy and the resulting decrease in edema. The initial change in BV upon starting DMT is termed pseudoatrophy, a reversible decrease in BV due to a loss of water from the brain parenchyma. Patients with clinically definite MS planning on initiating DMT were recruited and scanned at two time points prior to initiating therapy and two time points after initiating therapy to determine the change in water content of the brain.

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