Can J Neurol Sci. 2004 May;31(2):225-8
Brass SD, Narayanan S, Antel JP, Lapierre Y, Collins L, Arnold DL.
Montreal Neurological Hospital, Department of Neurology and Neurosurgery, Montreal, Quebec, Canada.
The pathophysiological basis for differences in disability in patients with multiple sclerosis is unclear.
We used magnetic resonance imaging to examine whether differences in disability in cohorts of multiple sclerosis patients with similar T2-weighted lesion volume and disease duration were associated with a more destructive disease process in the more disabled patients.
The benign and severely disabled groups had similar brain atrophy metrics and similar decreases of the neuronal marker, N-acetylaspartate, in the normal appearing white matter of the cerebrum on magnetic resonance spectroscopy examination in vivo.
The severely disabled cohort had more spinal cord atrophy.
The dissociation of spinal cord atrophy and cerebral atrophy between these two groups suggests that the difference between the more benign and more disabled groups cannot be explained by a more aggressive pathological process that is affecting the entire neuroaxis in a homogeneous fashion.