PT  - JOURNAL ARTICLE
AU  - Popescu, Veronica
AU  - Agosta, Federica
AU  - Hulst, Hanneke E
AU  - Sluimer, Ingrid C
AU  - Knol, Dirk L
AU  - Sormani, Maria Pia
AU  - Enzinger, Christian
AU  - Ropele, Stefan
AU  - Alonso, Julio
AU  - Sastre-Garriga, Jaume
AU  - Rovira, Alex
AU  - Montalban, Xavier
AU  - Bodini, Benedetta
AU  - Ciccarelli, Olga
AU  - Khaleeli, Zhaleh
AU  - Chard, Declan T
AU  - Matthews, Lucy
AU  - Palace, Jaqueline
AU  - Giorgio, Antonio
AU  - De Stefano, Nicola
AU  - Eisele, Philipp
AU  - Gass, Achim
AU  - Polman, Chris H
AU  - Uitdehaag, Bernard M J
AU  - Messina, Maria Jose
AU  - Comi, Giancarlo
AU  - Filippi, Massimo
AU  - Barkhof, Frederik
AU  - Vrenken, Hugo
AU  - , 
TI  - Brain atrophy and lesion load predict long term disability in multiple sclerosis
AID  - 10.1136/jnnp-2012-304094
DP  - 2013 Oct 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 1082--1091
VI  - 84
IP  - 10
4099  - http://jnnp.bmj.com/content/84/10/1082.short
4100  - http://jnnp.bmj.com/content/84/10/1082.full
SO  - J Neurol Neurosurg Psychiatry2013 Oct 01; 84
AB  - 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.