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

This large multicentre study looked at whether brain atrophy and lesion volumes predict subsequent 10 year clinical evolution in MS. 

The researchers looked at 261 MS patients with MR imaging at baseline and after 1-2 years, as well as EDSS at baseline and after 10 years. They calculated annualised whole brain atrophy, central brain atrophy and T2 lesion volumes. 

Linear regression models tested whether whole brain and central atrophy, lesion volume at baseline, follow-up and lesion volume change predicted 10 year EDSS and MS Severity Scale scores. They found that whole brain and central atrophy predicted EDSS at 10 years. The combined model with central atrophy and lesion volume change as MRI predictors predicted 10 year EDSS in the whole group and in the relapse onset group. Therefore, this study suggests that early brain atrophy rates are related to subsequent long term disability in MS, and that atrophy and lesion volume have complementary predictive value. These findings may help develop predictors of future disability in MS.

Authors: Popescu V, Agosta F, Hulst HE

Source: J Neurol Neurosurg Psychiatry. 2013 Mar 23. [Epub ahead of print]

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