Brain Damage is occurring even before diagnosis

Rojas JI, Patrucco L, Míguez J, Besada C, Cristiano E.Brain Atrophy in Radiologically Isolated Syndromes. J Neuroimaging. 2014. doi: 10.1111/jon.12182. [Epub ahead of print]

INTRODUCTION:The aim of this study was to compare brain atrophy in radiologically isolated syndrome (RIS), in clinically isolated syndrome (CIS), and in individuals with subjective complaints (ISC).

METHODS: Patients with RIS were included prospectively during June 2009 to June 2012. CIS patients and ISC were used to compare the RIS sample. An automated analysis tool, SIENAX, was used to obtain normalized total brain volume (NTBV), normalized cortical volume (NCV), and normalized white matter volume (NWMV).

RESULTS: A total of 10 RIS patients, 43 CIS patients, and 29 ISC were included. 
The NTBV in RIS was 1.56 mm3 × 10-6 , 1.52 × 10-6 in CIS, and 1.64 × 10-6 in ISC (P = .003);  The NCV in RIS was 0.59 × 10-6 , 0.55 × 10-6 in CIS, and 0.71 × 10-6 in ISC (P = .002), and NWMV in RIS was 1.1 × 10-6 , 1 × 10-6 in CIS and 1.12 × 10-6 in ISC. 

CONCLUSIONS: NTBV and NCV were significantly lower in RIS compared with ISC while no differences were observed in NWMV.

As ProfG has suggested before that it looks like damage to brain notably the grey matter (cortex) is occurring early and even before diagnosis. The Volume of the white matter does not appear to change but this is a balance between volume loss and swelling due to the disease. However, again it suggests that we should be getting on top of MS as soon as possible.