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.
BACKGROUND:
The pathophysiological basis for differences in disability in patients with multiple sclerosis is unclear.
METHODS:
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.
RESULTS:
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.
CONCLUSION:
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.