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Abstract：
BACKGROUND: Multiple sclerosis (MS) is a chronic autoimmune disease characterized by inflammatory and neurodegenerative processes leading to irreversible neurological impairment. Brain atrophy occurs early in the course of the disease at a rate greater than the general population. Brain volume loss (BVL) is associated with disability progression and cognitive impairment in patients with MS; hence its value as a potential target in monitoring and treating MS is discussed.
METHODS: A group of MS neurologists and neuro-radiologists reviewed the current literature on brain atrophy and discussed the challenges in assessing and implementing brain atrophy measurements in clinical practice. The panel used a voting system to reach a consensus and the votes were counted for the proposed set of questions for cognitive and brain atrophy assessments.
RESULTS: The panel of experts was able to identify recent studies, which demonstrated the correlation between BVL and future worsening of disability and cognition. The current evidence revealed that reduction of BVL could be achieved with different disease-modifying therapies (DMTs). BVL provided a better treatment and monitoring strategy when it is combined to the composite measures of \"no evidence of disease activity\" (NEDA). The panel recommended a set of cognitive assessment tools and MRI methods and software applications that may help in capturing and measuring the underlying MS pathology with high degree of specificity.
CONCLUSIONS: BVL was considered to be a useful measurement to longitudinally assess disease progression and cognitive function in patients with MS. Brain atrophy measurement was recommended to be incorporated into the concept of NEDA. Consequently, a consensus recommendation was reached in anticipation for implementation of the use of cognitive assessment and brain atrophy measurements on a regional level.
METHODS: A group of MS neurologists and neuro-radiologists reviewed the current literature on brain atrophy and discussed the challenges in assessing and implementing brain atrophy measurements in clinical practice. The panel used a voting system to reach a consensus and the votes were counted for the proposed set of questions for cognitive and brain atrophy assessments.
RESULTS: The panel of experts was able to identify recent studies, which demonstrated the correlation between BVL and future worsening of disability and cognition. The current evidence revealed that reduction of BVL could be achieved with different disease-modifying therapies (DMTs). BVL provided a better treatment and monitoring strategy when it is combined to the composite measures of \"no evidence of disease activity\" (NEDA). The panel recommended a set of cognitive assessment tools and MRI methods and software applications that may help in capturing and measuring the underlying MS pathology with high degree of specificity.
CONCLUSIONS: BVL was considered to be a useful measurement to longitudinally assess disease progression and cognitive function in patients with MS. Brain atrophy measurement was recommended to be incorporated into the concept of NEDA. Consequently, a consensus recommendation was reached in anticipation for implementation of the use of cognitive assessment and brain atrophy measurements on a regional level.
摘要：
背景：多发性硬化症（MS）是一种慢性自身免疫性疾病，其特征在于炎症和神经变性过程，导致不可逆的神经功能缺损。脑萎缩发生在疾病的早期，其发生率高于一般人群。脑容量损失（BVL）与MS患者的残疾进展和认知障碍有关；因此，讨论了其作为监测和治疗MS的潜在目标的价值。
方法：一组MS神经学家和神经放射科医师回顾了目前关于脑萎缩的文献，并讨论了在临床实践中评估和实施脑萎缩测量的挑战。小组使用投票系统达成共识，并对拟议的认知和脑萎缩评估问题进行了投票。
结果：专家小组能够确定最近的研究，这证明了BVL与未来残疾和认知恶化之间的相关性。目前的证据表明，BVL的降低可以通过不同的疾病改善疗法（DMT）来实现。当BVL与“无疾病活动证据”（NEDA）的综合措施相结合时，BVL提供了更好的治疗和监测策略。小组推荐了一组认知评估工具和MRI方法以及软件应用程序，这些工具可能有助于以高度的特异性捕获和测量潜在的MS病理。
结论：BVL被认为是纵向评估MS患者疾病进展和认知功能的有用指标。建议将脑萎缩测量纳入NEDA的概念。因此,我们达成了一项共识建议,预期在区域层面实施认知评估和脑萎缩测量.
方法：一组MS神经学家和神经放射科医师回顾了目前关于脑萎缩的文献，并讨论了在临床实践中评估和实施脑萎缩测量的挑战。小组使用投票系统达成共识，并对拟议的认知和脑萎缩评估问题进行了投票。
结果：专家小组能够确定最近的研究，这证明了BVL与未来残疾和认知恶化之间的相关性。目前的证据表明，BVL的降低可以通过不同的疾病改善疗法（DMT）来实现。当BVL与“无疾病活动证据”（NEDA）的综合措施相结合时，BVL提供了更好的治疗和监测策略。小组推荐了一组认知评估工具和MRI方法以及软件应用程序，这些工具可能有助于以高度的特异性捕获和测量潜在的MS病理。
结论：BVL被认为是纵向评估MS患者疾病进展和认知功能的有用指标。建议将脑萎缩测量纳入NEDA的概念。因此,我们达成了一项共识建议,预期在区域层面实施认知评估和脑萎缩测量.
