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Predicting short-term disability progression in early multiple sclerosis: added value of MRI parameters
  1. A Minneboo1,
  2. B Jasperse2,
  3. F Barkhof1,
  4. B M J Uitdehaag2,3,
  5. D L Knol3,
  6. V de Groot4,
  7. C H Polman2,
  8. J A Castelijns1
  1. 1
    MS Center of the VU University Medical Center, Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
  2. 2
    MS Center of the VU University Medical Center, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
  3. 3
    MS Center of the VU University Medical Center, Department of Clinical Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
  4. 4
    MS Center of the VU University Medical Center, Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands
  1. Arjan Minneboo, VU University Medical Center, Department of Radiology, PO Box 7057, 1007 MB Amsterdam, The Netherlands; a.minneboo{at}vumc.nl

Abstract

Objective: Magnetic resonance imaging (MRI) and clinical parameters are associated with disease progression in multiple sclerosis (MS). The aim of this study was to investigate whether adding MRI parameters to a model with only clinical parameters could improve these associations.

Methods: 89 patients (55 women) with recently diagnosed MS had clinical and MRI evaluation at baseline (time of diagnosis) and at follow-up after 2.2 years. Detailed clinical data were available, including disease type (relapse-onset or progressive-onset) and disability, as measured by the Expanded Disability Status Scale (EDSS). MRI parameters included Normalised Brain Volume (NBV) at baseline, percentage brain volume change (PBVC/year), T2- and T1-lesion loads and spinal cord abnormalities. Progression of disability (increase in EDSS of at least 1 point at follow-up) was the main outcome measure. For a model containing only clinical parameters, the added value of MRI parameters was tested using logistic regression.

Results: PBVC/year and lesion loads at follow-up were significantly higher in the group with progression. Adding PBVC/year to a clinical model improved the model, indicating that MRI parameters added independent information (p<0.001).

Conclusion: The rate of cerebral atrophy conveys added information for the progression of disability in patients with early MS, suggesting that clinical disability is determined by neurodegenerative changes as depicted by MRI.

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Footnotes

  • Competing interests: None declared.

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