Magnetic resonance disease severity scale (MRDSS) for patients with multiple sclerosis: A longitudinal study

Department of Neurology, University of Massachusetts, Boston, MA, USA.
Journal of the neurological sciences (Impact Factor: 2.47). 12/2011; 315(1-2):49-54. DOI: 10.1016/j.jns.2011.11.040
Source: PubMed


We previously described a composite MRI scale combining T1-lesions, T2-lesions and whole brain atrophy in multiple sclerosis (MS): the magnetic resonance disease severity scale (MRDSS).
Test strength of the MRDSS vs. individual MRI measures for sensitivity to longitudinal change.
We studied 84 MS patients over a 3.2±0.3 year follow-up. Baseline and follow-up T2-lesion volume (T2LV), T1-hypointense lesion volume (T1LV), and brain parenchymal fraction (BPF) were measured. MRDSS was the combination of standardized T2LV, T1/T2 ratio and BPF.
Patients had higher MRDSS at follow-up vs. baseline (p<0.001). BPF decreased (p<0.001), T1/T2 increased (p<0.001), and T2LV was unchanged (p>0.5). Change in MRDSS was larger than the change in MRI subcomponents. While MRDSS showed significant change in relapsing-remitting (RR) (p<0.001) and secondary progressive (SP) phenotypes (p<0.05), BPF and T1/T2 ratio changed only in RRMS (p<0.001). Longitudinal change in MRDSS was significantly different between RRMS and SPMS (p=0.0027); however, change in the individual MRI components did not differ. Evaluation with respect to predicting on-study clinical worsening as measured by EDSS revealed a significant association only for T2LV (p=0.038).
Results suggest improved sensitivity of MRDSS to longitudinal change vs. individual MRI measures. MRDSS has particularly high sensitivity in RRMS.

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    • "A major strength of this study is the inclusion of spinal cord involvement in MRDSS2. Previous MS MRI composite scale versions from our group and other groups have not included spinal cord metrics 1–4. Yet, a growing body of evidence indicates that spinal cord atrophy is common and highly relevant to disability in advanced stages of MS 9,10,12,13. "
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