Journal article
Predicting Clinical Progression in Multiple Sclerosis With the Magnetic Resonance Disease Severity Scale
Archives of neurology (Chicago), Vol.65(11), pp.1449-1453
11/01/2008
DOI: 10.1001/archneur.65.11.1449
PMCID: PMC2762216
PMID: 19001162
Abstract
Background: Individual magnetic resonance imaging (MRI) disease severity measures, such as atrophy or lesions, show weak relationships to clinical status in patients with multiple sclerosis (MS).
Objective: To combine MS-MRI measures of disease severity into a composite score.
Design: Retrospective analysis of prospectively collected data.
Setting: Community-based and referral subspecialty clinic in an academic hospital.
Patients: A total of 103 patients with MS, with a mean (SD) Expanded Disability Status Scale (EDSS) score of 3.3 (2.2), of whom 62 (60.2%) had the relapsing-remitting, 33 (32.0%) the secondary progressive, and 8 (7.8%) the primary progressive form.
Main Outcome Measures: Brain MRI measures included baseline T2 hyperintense (T2LV) and T1 hypointense (T1LV) lesion volume and brain parenchymal fraction (BPF), a marker of global atrophy. The ratio of T1LV to T2LV (T1: T2) assessed lesion severity. A Magnetic Resonance Disease Severity Scale (MRDSS) score, on a continuous scale from 0 to 10, was derived for each patient using T2LV, BPF, and T1: T2.
Results: The MRDSS score averaged 5.1 (SD, 2.6). Baseline MRI and EDSS correlations were moderate for BPF, T1: T2, and MRDSS and weak for T2LV. The MRDSS showed a larger effect size than the individual MRI components in distinguishing patients with the relapsing-remitting form from those with the secondary progressive form. Models containing either T2LV or MRDSS were significantly associated with disability progression during the mean (SD) 3.2 (0.3)-year observation period, when adjusting for baseline EDSS score.
Conclusion: Combining brain MRI lesion and atrophy measures can predict MS clinical progression and provides the basis for developing an MRI-based continuous scale as a marker of MS disease severity.
Details
- Title: Subtitle
- Predicting Clinical Progression in Multiple Sclerosis With the Magnetic Resonance Disease Severity Scale
- Creators
- Rohit Bakshi - Harvard UniversityMohit Neema - Harvard UniversityBrian C. Healy - Harvard UniversityZsuzsanna Liptak - Harvard UniversityRebecca A. Betensky - Harvard UniversityGuy J. Buckle - Harvard UniversitySusan A. Gauthier - Harvard UniversityJames Stankiewicz - Harvard UniversityDominik Meier - Harvard UniversitySvetlana Egorova - Harvard UniversityAshish Arora - Harvard UniversityZachary D. Guss - Harvard UniversityBonnie Glanz - Harvard UniversitySamia J. Khoury - Harvard UniversityCharles R. G. Guttmann - Harvard UniversityHoward L. Weiner - Harvard University
- Resource Type
- Journal article
- Publication Details
- Archives of neurology (Chicago), Vol.65(11), pp.1449-1453
- DOI
- 10.1001/archneur.65.11.1449
- PMID
- 19001162
- PMCID
- PMC2762216
- NLM abbreviation
- Arch Neurol
- ISSN
- 0003-9942
- eISSN
- 1538-3687
- Publisher
- American Medical Association
- Number of pages
- 5
- Grant note
- R01NS055083 / NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS)
- Language
- English
- Date published
- 11/01/2008
- Academic Unit
- Psychiatry
- Record Identifier
- 9984627323202771
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