MRI phenotypes based on cerebral lesions and atrophy in patients with multiple sclerosis

Shahamat Tauhid; Mohit Neema; Brian C Healy; Howard L Weiner; Rohit Bakshi

doi:10.1016/j.jns.2014.08.047

Back

MRI phenotypes based on cerebral lesions and atrophy in patients with multiple sclerosis

Journal article

Open access

Peer reviewed

MRI phenotypes based on cerebral lesions and atrophy in patients with multiple sclerosis

Shahamat Tauhid, Mohit Neema, Brian C Healy, Howard L Weiner and Rohit Bakshi

Journal of the neurological sciences, Vol.346(1-2), pp.250-254

11/15/2014

DOI: 10.1016/j.jns.2014.08.047

PMID: 25220114

Files and links (1)

url

https://doi.org/10.1016/j.jns.2014.08.047View

Published (Version of record) Open Access

Abstract

While disease categories (i.e. clinical phenotypes) of multiple sclerosis (MS) are established, there remains MRI heterogeneity among patients within those definitions. MRI-defined lesions and atrophy show only moderate inter-correlations, suggesting that they represent partly different processes in MS. We assessed the ability of MRI-based categorization of cerebral lesions and atrophy in individual patients to identify distinct phenotypes. We studied 175 patients with MS [age (mean ± SD) 42.7 ± 9.1 years, 124 (71%) women, Expanded Disability Status (EDSS) score 2.5 ± 2.3, n = 18 (10%) clinically isolated demyelinating syndrome (CIS), n=115 (66%) relapsing-remitting (RR), and n = 42 (24%) secondary progressive (SP)]. Brain MRI measures included T2 hyperintense lesion volume (T2LV) and brain parenchymal fraction (to assess whole brain atrophy). Medians were used to create bins for each parameter, with patients assigned a low or high severity score. Four MRI phenotype categories emerged: Type I = low T2LV/mild atrophy [n = 67 (38%); CIS = 14, RR = 47, SP = 6]; Type II = high T2LV/mild atrophy [n = 21 (12%); RR = 19, SP = 2]; Type III = low T2LV/high atrophy [n = 21 (12%); CIS = 4, RR = 16, SP = 1]; and Type IV = high T2LV/high atrophy [n = 66 (38%); RR = 33, S P = 33]. Type IV was the most disabled and was the only group showing a correlation between T2LV vs. BPF and MRI vs. EDSS score (all p < 0.05). We described MRI-categorization based on the relationship between lesions and atrophy in individual patients to identify four phenotypes in MS. Most patients have congruent extremes related to the degree of lesions and atrophy. However, many have a dissociation. Longitudinal studies will help define the stability of these patterns and their role in risk stratification.

Adult

Atrophy - pathology

Brain - pathology

Demyelinating Diseases - pathology

Disability Evaluation

Female

Humans

Magnetic Resonance Imaging

Male

Middle Aged

Multiple Sclerosis - pathology

Multiple Sclerosis, Chronic Progressive - pathology

Multiple Sclerosis, Relapsing-Remitting - pathology

Phenotype

Severity of Illness Index

Young Adult

Details

Title: Subtitle: MRI phenotypes based on cerebral lesions and atrophy in patients with multiple sclerosis
Creators: Shahamat Tauhid - Brigham and Women's Hospital
Mohit Neema - Brigham and Women's Hospital
Brian C Healy - Brigham and Women's Hospital
Howard L Weiner - Brigham and Women's Hospital
Rohit Bakshi - Brigham and Women's Hospital
Resource Type: Journal article
Publication Details: Journal of the neurological sciences, Vol.346(1-2), pp.250-254
DOI: 10.1016/j.jns.2014.08.047
PMID: 25220114
ISSN: 0022-510X
eISSN: 1878-5883
Language: English
Date published: 11/15/2014
Academic Unit: Psychiatry
Record Identifier: 9984627194902771

Metrics

3 Record Views

27 Times Cited - Web of Science

See more details