“…41 This phenomenon is called pseudo atrophy, and it seems to be directly associ ated with the resolution of ongoing white matter inflam mation induced at the time of treatment initiation. 32,[44][45][46][47] To identify pseudo atrophy during a clinical trial, brain volume should be measured every 3-6 months. 25 In addition to disease specific changes, lifestyle related factors (including alcohol consumption, smoking, dehy dration and BMI), genetics (such as the presence of an APOE*ε4 allele), and concomitant pathophysio logical conditions (such as diabetes and/or other cardio vascular risk factors) can affect brain volume.…”