Clinical and magnetic resonance imaging predictors of disease progression in multiple sclerosis: a nine-year follow-up study. (February 2014)

• Record Type: Journal Article
• Authors: Lavorgna, L; Bonavita, S; Ippolito, D; Lanzillo, R; Salemi, G; Patti, F; Valentino, P; Coniglio, G; Buccafusca, M; Paolicelli, D; d'Ambrosio, A; Bresciamorra, V; Savettieri, G; Zappia, M; Alfano, B; Gallo, A; Simone, IL; Tedeschi, G
• Is Part Of: Multiple sclerosis. Volume 20:Number 2(2014)
• Page Start: 220
• Page End: 226
• Publication Date: 2014-02
• Subjects: Magnetic resonance imaging -- follow-up -- multiple sclerosis -- clinical predictors -- gray matter atrophy; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/1352458513494958
• Languages: English
• ISSNs: 1352-4585

Abstract

Objective: The objective of this paper is to identify clinical or magnetic resonance imaging (MRI) predictors of long-term clinical progression in a large cohort of multiple sclerosis (MS) patients. Methods: A total of 241 relapsing–remitting (RR) MS patients were included in a nine-year follow-up (FU) study. The reference MRIs were acquired at baseline (BL) as part of a multicenter, cross-sectional, clinical-MRI study. Volumetric MRI metrics were measured by a fully automated, operator-independent, multi-parametric segmentation method. Clinical progression was evaluated as defined by: conversion from RR to secondary progressive (SP) disease course; progression of Expanded Disability Status Scale (EDSS); achievement and time to reach EDSS 4. Results: We concluded that conversion from RR to SP (OR 0.79; CI 0.7–0.9), progression of EDSS (OR 0.85; CI 0.77–0.93), achievement of EDSS 4 (OR 0.8; CI 0.7–0.9), and time to reach EDSS 4 (HR 0.88; CI 0.82–0.94) were all predicted by BL gray matter (GM) volume and, except for progression of EDSS, by BL EDSS (respectively: (OR 2.88; CI 1.9–4.36), (OR 2.7; CI 1.7–4.2), (HR 3.86; CI 1.94–7.70)). Conclusions: BL GM volume and EDSS are the best long-term predictors of disease progression in RRMS patients with a relatively long and mild disease.