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 ,
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.