Width of 3. Ventricle: Reference Values and Clinical Relevance in a Cohort of Patients with Relapsing Remitting Multiple Sclerosis

Martin Müller 1, 2, *, Regina Esser1, Katarina Kötter1, Jan Voss1, Achim Müller1, Petra Stellmes1
1 Department of Neurology, Luzerner Kantonsspital, Spitalstrasse, CH-6000 Luzern, Switzerland
2 Department of Internal Medicine, Spital Zollikerberg, Trichtenhauserstr. 20, CH-8125 Zollikerberg, Switzerland

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© Müller et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Neurology, Luzerner Kantonsspital, Spitalstrasse, CH-6000 Lucerne, Switzerland; Tel: +41 41 205 5149; Fax: +41 41 205 2168; E-mail:



To estimate the quantity of multiple sclerosis (MS) patients with brain atrophy as indicated by third ventricular enlargement using transcranial colourcoded ultrasound (TCCS).


The width of the 3. ventricle was assessed by TCCS in 70 healthy controls (male 31, female 39, mean age 41 ± 15 years, age range 18 – 79 years), and in a cohort of 54 patients with relapsing remitting MS (male 16, female 38, mean age 40 ± 10 years, median EDSS 2 [1-3]).


In the controls, the width of the 3. ventricle increased with age (without any sex differences) from 3.0 ± 0.76 mm in the age group < 40 years to 4.0 ± 0.74 mm in the age group of 60 years or more (ANOVA p=0.0001). Derived from regression analysis, the upper limit of the 95% Confidence Interval for each year provided cutoff points according to which 14 of 54 patients (25%) exhibited an enlarged 3. ventricle. In a multivariate regression analysis, the width of the 3. ventricle over all MS patients was significantly related to EDSS (Spearman rho , r=0.446, p<0.005) and to MS duration (r=0.319, p<0.005).


Even in MS patients in good clinical conditions the rate of patients with brain atrophy determined by TCCS is high.

Keywords: Brain anatomy, brain atrophy, disease modifying therapy, multiple sclerosis, ultrasound, ventricle size.