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<.001). Conclusion: rate of cerebral atrophy conveys added information for progression of disability in early MS patient, suggesting that clinical disability is determined by neurodegenerative changes as depicted by MRI.