Regional Brain Atrophy in Multiple Sclerosis: increasing sensitivity to differences in relapsing-remitting and secondary-progressive disease

Introduction Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease, with relapsing-remitting (RR) and secondary-progressive (SP) subgroups considered as different phases in the progression of the disease. Pathologic and imaging studies suggest that the development of permanent neurologic impairment in MS is associated with progressive brain and spinal cord atrophy, and atrophy has been suggested as a potential marker of disease progression. Nevertheless, despite differences in the pathological progression of the disease, it has been difficult to establish significant differences between RR and SP groups in measures of the rate of global brain atrophy or ventricular growth [1,2,3].