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 (http://creativecommons.org/licenses/by-nc/3.0/) 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: martin.mueller@luks.ch


Abstract

Objectives:

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

Methods:

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]).

Results:

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).

Conclusions:

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.