Magnetic resonance imaging correlates of physical disability in relapse onset multiple sclerosis of long disease duration

Institute of Neurology, University College London, UK.
Multiple Sclerosis (Impact Factor: 4.82). 06/2013; 20(1). DOI: 10.1177/1352458513492245
Source: PubMed


Understanding long-term disability in multiple sclerosis (MS) is a key goal of research; it is relevant to how we monitor and treat the disease.
The Magnetic Imaging in MS (MAGNIMS) collaborative group sought to determine the relationship of brain lesion load, and brain and spinal cord atrophy, with physical disability in patients with long-established MS.
Patients had a magnetic resonance imaging (MRI) scan of their brain and spinal cord, from which we determined brain grey (GMF) and white matter (WMF) fractional volumes, upper cervical spinal cord cross-sectional area (UCCA) and brain T2-lesion volume (T2LV). We assessed patient disability using the Expanded Disability Status Scale (EDSS). We analysed associations between EDSS and MRI measures, using two regression models (dividing cohort by EDSS into two and four sub-groups).
In the binary model, UCCA (p < 0.01) and T2LV (p = 0.02) were independently associated with the requirement of a walking aid. In the four-category model UCCA (p < 0.01), T2LV (p = 0.02) and GMF (p = 0.04) were independently associated with disability.
Long-term physical disability was independently linked with atrophy of the spinal cord and brain T2 lesion load, and less consistently, with brain grey matter atrophy. Combinations of spinal cord and brain MRI measures may be required to capture clinically-relevant information in people with MS of long disease duration.

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Available from: Alex Rovira, Sep 28, 2014
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    • "The existence of a correlation between hyperintense lesion load in T2-weighted images and disability level (EDSS) remains controversial (Barkhof 2002; Charil et al. 2003; Popescu et al. 2013; Kearney et al. 2014). Here, we found a higher disease severity (MSSS) in MS ? "
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    • "T2 lesion volume is positively correlated with disability measured by EDSS at 2 [47] and 10 years of follow-up [48] and number of relapses after 2 years of follow up [34, 47]. A recent study evaluated MRI correlates of disability in a cohort of 159 patients with relapsing-remitting MS (median EDSS = 4) followed for mean of 26 years from first attack and found that T2 lesion volume was associated with long-term disability and independent of cervical spinal cord atrophy and grey matter atrophy [49]. Similarly, a study of 107 MS patients followed for mean of 20 years from first attack showed that T2 lesion volume correlated with 20-year EDSS (rs = 0.48–0.67) "
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