To assess in an outpatient setting the application of volumetrics with brain MRI among young people with multiple sclerosis (MS).

Research on brain atrophy in MS has illuminated how inflammation and neurodegenerative processes lead to cognitive and neurologic declines. However, brain volume assessment is rarely used in routine practice. Here, we examined predominantly pediatric onset MS and some younger adult-onset MS patients who underwent routine brain MRI including volumetrics. Our goal was to assess the impact of brain volume change on clinical outcomes including SDMT in this relatively young and stable MS subset.

77 patients with pediatric or adult onset RRMS or CIS, 31 years of age or younger, were evaluated with at least two MRI studies. Volume data was computed on MRI images with icobrain ms software, compared to age- and sex-related norms and adjusted for differences across the various Siemens 3T scanners. Changes in volumes of whole brain (WB), white matter (WM), grey matter (GM), lateral ventricles (LV), and thalamus were calculated as an average annualized percent brain volume change per year.

The mean patient age was 21.6 years (range 12-31); 70% were female. The annual mean decrease of WB volume: -0.473%, WM: -0.390%, GM: -0.517%, thalamus: -0.552%, and annual LV volume increase: 1.78%. A total of 32.5% of patients had an annual decrease in GM volume >0.8% (the 90% threshold for measurement error). 29.9% of patients had LV volumes increase >3.5%. Whole brain volume loss and lateral ventricle increase was significantly correlated, r=-0.34 (p=0.002). Clinical and demographic features between those whose brain volume declined and those whose brain volumes remained stable will be presented.

Quantitative MRI is a useful technique which has only begun to be incorporated into clinical practice. A proportion of young otherwise stable patients with RRMS show brain volume loss under computer-assisted analyses.