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Multiple Sclerosis International
Volume 2013, Article ID 231345, 8 pages
Research Article

Bimonthly Evolution of Cortical Atrophy in Early Relapsing-Remitting Multiple Sclerosis over 2 Years: A Longitudinal Study

1Department of Neurology, Buffalo Neuroimaging Analysis Center, The Jacobs Neurological Institute, Buffalo, NY 14203, USA
2Department of Biostatistics, Buffalo Neuroimaging Analysis Center, Buffalo, NY 14203, USA
3Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, 121 08 Prague, Czech Republic
4Department of Radiology, First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, 121 08 Prague, Czech Republic

Received 2 May 2012; Revised 1 December 2012; Accepted 15 December 2012

Academic Editor: Caterina Mainero

Copyright © 2013 Robert Zivadinov et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We investigated the evolution of cortical atrophy in patients with early relapsing-remitting (RR) multiple sclerosis (MS) and its association with lesion volume (LV) accumulation and disability progression. 136 of 181 RRMS patients who participated in the Avonex-Steroids-Azathioprine study were assessed bimonthly for clinical and MRI outcomes over 2 years. MS patients with disease duration (DD) at baseline of ≤24 months were classified in the early group (DD of 1.2 years, ), while patients with DD > 24 months were classified in the late group (DD of 7.1 years, ). Mixed effect model analysis was used to investigate the associations. Significant changes in whole brain volume (WBV) ( ), cortical volume (CV) ( ), and in T2-LV ( ) were detected. No significant MRI percent change differences were detected between early and late DD groups over 2 years, except for increased T2-LV accumulation between baseline and year 2 in the early DD group ( ). No significant associations were found between changes in T2-LV and CV over the followup. Change in CV was related to the disability progression over the 2 years, after adjusting for DD ( ). Significant cortical atrophy, independent of T2-LV accumulation, occurs in early RRMS over 2 years, and it is associated with the disability progression.