Brain atrophy and lesion load predict long term disability in multiple sclerosis

This retrospective study as part of the MAGNIMS collaboration looked at MR imaging at baseline and after one year and two years as well as EDSS scores at baseline and after ten years in 261 people with MS. The MRI measures which were analysed included whole brain atrophy, central brain atrophy rates and T2 lesion volumes. The study included people with CIS, SPMS, PPMS and RRMS. Those with RRMS were classified as minimally impaired or moderately impaired depending on their baseline EDSS.

The researchers found that whole brain and central atrophy predicted EDSS at ten years corrected for imaging protocol, baseline EDSS and disease modifying therapy. The combined approach with central atrophy and lesion volume change as MRI predictors, predicted ten year EDSS in the whole group and in the relapsing group. Within the subgroups, central atrophy was predictive in the minimally impaired relapse onset patients, lesion volumes in moderately impaired relapse onset group and whole brain atrophy in the PPMS group. In conclusion, this study suggests the complementary predictive value of atrophy and lesion volumes for predicting long term disability in MS.

Authors: Popescu V, Agosta F
Source: J Neurol Neurosurg Psychiatry. 2013 Oct;84(10):1082-91. doi: 10.1136/jnnp-2012-304094. Epub 2013 Mar 23.

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