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Multiple Sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system, and the second cause of neurological disability after trauma in young adults in the Western world. The efficacy of disease-modifying treatments (DMTs) in relapsing-remitting (RR) and secondary-progressive (SP) MS is usually surrogated by assessing new/enlarged T2 and gadolinium (Gd)-enhancing lesions on magnetic resonance imaging (MRI) scans. More recently, brain atrophy has been incorporated as an outcome measure in MS clinical trials due to its reproducibility, correlation with disability, and detectability from early disease stages. Brain atrophy measures, however, could lead to equivocal conclusions if a series of factors are not taken into account, particularly the influence of inflammation.

Brain Atrophy as a Measure of Neuroprotective Drug Effects in Multiple Sclerosis: Influence of Inflammation