Linear measures for assessing gray matter atrophy in Multiple Sclerosis

The the bicaudate ratio (BCR) is increased in MS and is more closely associated with cognitive dysfunction than are other magnetic resonance imaging surrogate markers including whole-brain atrophy. Increased BCR is best explained by frontal horn ventricular enlargement due to atrophy of deep frontal subcortical white matter. This highlights the close relationship between subcortical atrophy and cognitive impairment in patients with MS (read more) and AD (read more).

Fluid-attenuated inversion-recovery magnetic resonance imaging scan of a patient with multiple sclerosis showing the technique of determining the bicaudate ratio (BCR). The BCR is the minimum intercaudate distance (solid line) divided by brain width along the same line (dashed line).

Bicaudate ratio. The yellow represents the distance between the two apices of the caudate nuclei. The inner skull dimension is shown in turquoise. The bicaudate ratio is derived by dividing the ventricular dimension (yellow) by the inner skull dimension

However, although the bicaudate ratio is a fairly good measure of caudate atrophy, seems to be poor measures of caudate size when no atrophy is present (read more). 

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