Brain atrophy and lesion load predict long term disability in multiple sclerosis
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- 23 March 2013
- journal article
- multiple sclerosis
- Published by BMJ in Journal of Neurology, Neurosurgery & Psychiatry
- Vol. 84 (10), 1082-1091
- https://doi.org/10.1136/jnnp-2012-304094
Abstract
Objective To determine whether brain atrophy and lesion volumes predict subsequent 10 year clinical evolution in multiple sclerosis (MS). Design From eight MAGNIMS (MAGNetic resonance Imaging in MS) centres, we retrospectively included 261 MS patients with MR imaging at baseline and after 1–2 years, and Expanded Disability Status Scale (EDSS) scoring at baseline and after 10 years. Annualised whole brain atrophy, central brain atrophy rates and T2 lesion volumes were calculated. Patients were categorised by baseline diagnosis as primary progressive MS (n=77), clinically isolated syndromes (n=18), relapsing–remitting MS (n=97) and secondary progressive MS (n=69). Relapse onset patients were classified as minimally impaired (EDSS=0–3.5, n=111) or moderately impaired (EDSS=4–6, n=55) according to their baseline disability (and regardless of disease type). Linear regression models tested whether whole brain and central atrophy, lesion volumes at baseline, follow-up and lesion volume change predicted 10 year EDSS and MS Severity Scale scores. Results In the whole patient group, whole brain and central atrophy predicted EDSS at 10 years, corrected for imaging protocol, baseline EDSS and disease modifying treatment. The combined model with central atrophy and lesion volume change as MRI predictors predicted 10 year EDSS with R2=0.74 in the whole group and R2=0.72 in the relapse onset group. In subgroups, central atrophy was predictive in the minimally impaired relapse onset patients (R2=0.68), lesion volumes in moderately impaired relapse onset patients (R2=0.21) and whole brain atrophy in primary progressive MS (R2=0.34). Conclusions This large multicentre study points to the complementary predictive value of atrophy and lesion volumes for predicting long term disability in MS.Keywords
This publication has 41 references indexed in Scilit:
- Thalamic Damage Predicts the Evolution of Primary-Progressive Multiple Sclerosis at 5 YearsAmerican Journal of Neuroradiology, 2011
- Early central atrophy rate predicts 5 year clinical outcome in multiple sclerosisJournal of Neurology, Neurosurgery & Psychiatry, 2010
- Predicting short-term disability progression in early multiple sclerosis: added value of MRI parametersJournal of Neurology, Neurosurgery & Psychiatry, 2008
- Predicting progression in primary progressive multiple sclerosis: A 10‐year multicenter studyAnnals of Neurology, 2008
- Regional brain atrophy development is related to specific aspects of clinical dysfunction in multiple sclerosisNeuroImage, 2007
- Focal cortical atrophy in multiple sclerosis: Relation to lesion load and disabilityNeuroImage, 2007
- Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”Annals of Neurology, 2005
- The relationship between whole brain volume and disability in multiple sclerosis: A comparison of normalized gray vs. white matter with misclassification correctionNeuroImage, 2005
- Progressive ventricular enlargement in patients with clinically isolated syndromes is associated with the early development of multiple sclerosisJournal of Neurology, Neurosurgery & Psychiatry, 2002
- Progressive cerebral atrophy in multiple sclerosis A serial MRI studyBrain, 1996