Regional assessment of brain atrophy: a novel approach to achieve a more complete picture of tissue damage associated with central nervous system disorders?

摘要

The progressive development of brain atrophy is a well-known feature of many central nervous system (CNS) disorders and can be measured in vivo accurately and reliably using MR imaging. Therefore, during the last decade or so, a number of MR imaging-based methods and postprocessing analysis tools have been developed for quantifying global and regional brain tissue loss associated with neurologic conditions. In general, there has been a move from seminal methods based on subjective visual ratings, which were time-consuming, labor-intensive, and poorly reproducible, to the use of sophisticated computerized tools that have made brain atrophy measurements reproducible and potentially applicable to routine clinical activity. The massive body of work performed in this field has convincingly shown that there is a strict correlation between the extent of overall brain tissue loss with the clinical manifestations, in terms of both neuropsychologic impairment and locomotor disability, detected in patients affected by various neurologic diseases. This has been shown to be the case not only in neurodegenerative diseases, such as Alzheimer disease (AD),1 but also in inflammatory-demyeh'-nating disorders, such as multiple sclerosis (MS).2 However, given the fact that neurologic disorders may affect the brain unevenly, and given the availability of novel technical approaches, a large amount of research work has been devoted to achieve a more complete picture of the extent of brain tissue loss on a regional basis, with the ultimate goal of developing more sensitive neuroimaging markers of disease-related pathology.