RT Journal Article SR Electronic T1 Brain atrophy and lesion load predict long term disability in multiple sclerosis JF Journal of Neurology, Neurosurgery & Psychiatry JO J Neurol Neurosurg Psychiatry FD BMJ Publishing Group Ltd SP 1082 OP 1091 DO 10.1136/jnnp-2012-304094 VO 84 IS 10 A1 Popescu, Veronica A1 Agosta, Federica A1 Hulst, Hanneke E A1 Sluimer, Ingrid C A1 Knol, Dirk L A1 Sormani, Maria Pia A1 Enzinger, Christian A1 Ropele, Stefan A1 Alonso, Julio A1 Sastre-Garriga, Jaume A1 Rovira, Alex A1 Montalban, Xavier A1 Bodini, Benedetta A1 Ciccarelli, Olga A1 Khaleeli, Zhaleh A1 Chard, Declan T A1 Matthews, Lucy A1 Palace, Jaqueline A1 Giorgio, Antonio A1 De Stefano, Nicola A1 Eisele, Philipp A1 Gass, Achim A1 Polman, Chris H A1 Uitdehaag, Bernard M J A1 Messina, Maria Jose A1 Comi, Giancarlo A1 Filippi, Massimo A1 Barkhof, Frederik A1 Vrenken, Hugo A1 on behalf of the MAGNIMS Study Group YR 2013 UL http://jnnp.bmj.com/content/84/10/1082.abstract 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.