Patients with MS appear to have greater brain atrophy than individuals without MS, and brain atrophy varies between different forms of MS, according to a trial published in the July 26 issue of the journal Neurology.

The study included 597 MS patients and 104 subjects without MS. Magnetic resonance imaging (MRI) was used to compare gray matter, white matter and the number of lesions in the brains of all participants.

The white matter of the brain is made up of nerve fibers that are covered in myelin, and the gray matter of the brain is made up of nerve fibers that are not covered in myelin.

The investigators found significant differences in gray and white matter between the MS patients and those without MS. For example, the MS patients had higher amounts of abnormal white matter and lower amounts of gray matter.

In addition, significant differences in white and gray matter were found between the 427 patients with relapsing-remitting MS and the 140 patients with secondary progressive MS. The amounts of white matter and gray matter were both significantly lower in the secondary progressive MS patients than the relapsing-remitting patients. The amount of abnormal white matter was also significantly higher in those with secondary progressive as compared with the relapsing-remitting course.

The authors observed that the number of lesions, which is also known as lesion load, was related to both white matter atrophy and gray matter atrophy. The subjects with secondary progressive MS had significantly more atrophy of both white and gray matter and a significantly higher lesion load than those with relapsing-remitting MS.

Furthermore, lesion load, white matter atrophy and gray matter atrophy were all significantly related to scores on the Expanded Disability Status Scale and age at disease onset. The researchers noted that this finding suggests that the lesion load and brain atrophy are worse in patients who experience disease onset at a younger age.

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