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September 2019; 6 (5) ArticleOpen Access

Lesion activity and chronic demyelination are the major determinants of brain atrophy in MS

Chenyu Wang, Michael H. Barnett, Con Yiannikas, Joshua Barton, John Parratt, Yuyi You, Stuart L. Graham, Alexander Klistorner
First published July 16, 2019, DOI: https://doi.org/10.1212/NXI.0000000000000593
Chenyu Wang
From the Brain and Mind Centre (C.W., M.H.B., J.B.), Sydney Medical School, University of Sydney; Sydney Neuroimaging Analysis Centre (C.W., M.H.B.); Royal North Shore Hospital (C.Y., J.P.); Save Sight Institute (Y.Y., A.K.), Sydney Medical School, University of Sydney; and Faculty of Medicine and Health Sciences (S.L.G., A.K.), Macquarie University, Sydney, NSW, Australia.
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Michael H. Barnett
From the Brain and Mind Centre (C.W., M.H.B., J.B.), Sydney Medical School, University of Sydney; Sydney Neuroimaging Analysis Centre (C.W., M.H.B.); Royal North Shore Hospital (C.Y., J.P.); Save Sight Institute (Y.Y., A.K.), Sydney Medical School, University of Sydney; and Faculty of Medicine and Health Sciences (S.L.G., A.K.), Macquarie University, Sydney, NSW, Australia.
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Con Yiannikas
From the Brain and Mind Centre (C.W., M.H.B., J.B.), Sydney Medical School, University of Sydney; Sydney Neuroimaging Analysis Centre (C.W., M.H.B.); Royal North Shore Hospital (C.Y., J.P.); Save Sight Institute (Y.Y., A.K.), Sydney Medical School, University of Sydney; and Faculty of Medicine and Health Sciences (S.L.G., A.K.), Macquarie University, Sydney, NSW, Australia.
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Joshua Barton
From the Brain and Mind Centre (C.W., M.H.B., J.B.), Sydney Medical School, University of Sydney; Sydney Neuroimaging Analysis Centre (C.W., M.H.B.); Royal North Shore Hospital (C.Y., J.P.); Save Sight Institute (Y.Y., A.K.), Sydney Medical School, University of Sydney; and Faculty of Medicine and Health Sciences (S.L.G., A.K.), Macquarie University, Sydney, NSW, Australia.
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John Parratt
From the Brain and Mind Centre (C.W., M.H.B., J.B.), Sydney Medical School, University of Sydney; Sydney Neuroimaging Analysis Centre (C.W., M.H.B.); Royal North Shore Hospital (C.Y., J.P.); Save Sight Institute (Y.Y., A.K.), Sydney Medical School, University of Sydney; and Faculty of Medicine and Health Sciences (S.L.G., A.K.), Macquarie University, Sydney, NSW, Australia.
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Yuyi You
From the Brain and Mind Centre (C.W., M.H.B., J.B.), Sydney Medical School, University of Sydney; Sydney Neuroimaging Analysis Centre (C.W., M.H.B.); Royal North Shore Hospital (C.Y., J.P.); Save Sight Institute (Y.Y., A.K.), Sydney Medical School, University of Sydney; and Faculty of Medicine and Health Sciences (S.L.G., A.K.), Macquarie University, Sydney, NSW, Australia.
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Stuart L. Graham
From the Brain and Mind Centre (C.W., M.H.B., J.B.), Sydney Medical School, University of Sydney; Sydney Neuroimaging Analysis Centre (C.W., M.H.B.); Royal North Shore Hospital (C.Y., J.P.); Save Sight Institute (Y.Y., A.K.), Sydney Medical School, University of Sydney; and Faculty of Medicine and Health Sciences (S.L.G., A.K.), Macquarie University, Sydney, NSW, Australia.
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Alexander Klistorner
From the Brain and Mind Centre (C.W., M.H.B., J.B.), Sydney Medical School, University of Sydney; Sydney Neuroimaging Analysis Centre (C.W., M.H.B.); Royal North Shore Hospital (C.Y., J.P.); Save Sight Institute (Y.Y., A.K.), Sydney Medical School, University of Sydney; and Faculty of Medicine and Health Sciences (S.L.G., A.K.), Macquarie University, Sydney, NSW, Australia.
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Citation
Lesion activity and chronic demyelination are the major determinants of brain atrophy in MS
Chenyu Wang, Michael H. Barnett, Con Yiannikas, Joshua Barton, John Parratt, Yuyi You, Stuart L. Graham, Alexander Klistorner
Neurol Neuroimmunol Neuroinflamm Sep 2019, 6 (5) e593; DOI: 10.1212/NXI.0000000000000593

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    Figure 1 Segmentation of lesional, perilesional, and normal-appearing white matter displayed on baseline T1 image

    Red represents lesion core, green represents lesion “rim,” perilesional white matter (PLWM) layers (layer 1 and layer 5) are yellow and magenta, and NAWM layer (layer 10) is blue. Layer number represents distance from the lesion in mm.

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    Figure 2 The average T1 hypointensity profile (mean ± SD) normalized by T1 intensity in NAWM
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    Figure 3 Correlation plots between PBVC and 5 individually significant variables

    (A) Baseline lesion volume (vertical scale units, mm3); (B) new lesion volume (vertical scale units, mm3); (C) baseline NAWM RD (vertical scale units, μm2/ms); (D) change in lesion MD (vertical scale units, μm2/ms); and (E) change in NAWM RD (vertical scale units, μm2/ms). Two parallel lines represent 95% CI. PBVC = percent brain volume change.

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    Figure 4 Change of AD and RD in lesion core, lesion “rim,” perilesional, and normal-appearing white matter

    Error bars represent SE. AD = axial diffusivity; RD = radial diffusivity.

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    Figure 5 PBVC linear regression analysis

    Two parallel lines represent 95% CI. PBVC = percent brain volume change.

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