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Table 2 Advantages and disadvantages of brain volume assessment in MS

From: A regional consensus recommendation on brain atrophy as an outcome measure in multiple sclerosis

Advantages

 

Whole brain atrophy is easy to measure

Brain atrophy is a “summary measure” of the irreversible/destructive pathological process of MS

Whole brain atrophy is highly reproducible and sensitive to disease-related

changes

Correlates with disability, cognitive impairment and fatigue

Disadvantages:

 

End-stage phenomenon

Pseudoatrophy effect (first 6–12 months)

Fluctuations: steroids, hydration

Co-morbidities: smoking, alcohol, high BMI, etc.

MRI technical confounding factors

Time consuming: reimbursement?

Not enough evidence to use atrophy measures to assess and predict individual treatment response

  1. BMI Body Mass Index