Amir-Hadi Maghzi1, Nisha Revirajan2, Laura J Julian3, Rebecca Spain4, Ellen M Mowry5, Shuang Liu6, Chengshi Jin7, Ari J Green2, Charles E McCulloch7, Daniel Pelletier6, Emmanuelle Waubant8. 1. Departments of Neurology, University of California San Francisco, San Francisco, CA, United States. Electronic address: hadi.maghzi@gmail.com. 2. Departments of Neurology, University of California San Francisco, San Francisco, CA, United States. 3. Departments of Internal Medicine, University of California San Francisco, San Francisco, CA, United States. 4. Department of Neurology, Oregon Health and Science University, OR, United States. 5. Department of Neurology, Johns Hopkins University, Baltimore, MD, United States. 6. Department of Neurology, Yale school of medicine, New Haven, CT, United States. 7. Departments of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States. 8. Departments of Neurology, University of California San Francisco, San Francisco, CA, United States; Departments of Pediatrics, University of California San Francisco, San Francisco, CA, United States.
Abstract
OBJECTIVES: To study the association between changes in brain magnetic resonance imaging (MRI) and clinical outcomes in early MS. METHODS:MS patients within 12 months of onset were enrolled and followed up to 3 years. Clinical measures included Symbol Digit Modalities Test (SDMT), MS Functional Composite (MSFC) and low contrast letter acuity (LCLA). MRI outcomes included brain volume changes measured by SIENA and SIENAX normalized measurements [brain parenchymal volume (BPV), normal-appearing white and gray matter volume (NAWMV and GMV) and T2 lesion volume (T2LV)]. Mixed model regression measured time trends and associations between imaging and clinical outcome. RESULTS:Forty-three patients were enrolled within 7.5±4.9 months of onset. Baseline T2 lesion volume predicted subsequent changes in Paced Auditory Serial Addition Test (PASAT) (p=0.004), whereas baseline measures of atrophy including BPV, GMV, and NAWMV predicted longitudinal changes in MSFC (p=0.016, p=0.040, p=0.021, respectively) and Timed-25 Foot Walk (p<0.05). Each 1% decrease in SIENA was associated with 1.14 point decrease in SDMT score (p=0.03). Each 1% decrease in brain volume SIENA was associated with almost 1.5 letters decrease on LCLA (p=0.02). CONCLUSION: Measures of lesion volume and overall brain volume were associated with different long-term clinical outcome measures in early MS.
RCT Entities:
OBJECTIVES: To study the association between changes in brain magnetic resonance imaging (MRI) and clinical outcomes in early MS. METHODS: MS patients within 12 months of onset were enrolled and followed up to 3 years. Clinical measures included Symbol Digit Modalities Test (SDMT), MS Functional Composite (MSFC) and low contrast letter acuity (LCLA). MRI outcomes included brain volume changes measured by SIENA and SIENAX normalized measurements [brain parenchymal volume (BPV), normal-appearing white and gray matter volume (NAWMV and GMV) and T2 lesion volume (T2LV)]. Mixed model regression measured time trends and associations between imaging and clinical outcome. RESULTS: Forty-three patients were enrolled within 7.5±4.9 months of onset. Baseline T2 lesion volume predicted subsequent changes in Paced Auditory Serial Addition Test (PASAT) (p=0.004), whereas baseline measures of atrophy including BPV, GMV, and NAWMV predicted longitudinal changes in MSFC (p=0.016, p=0.040, p=0.021, respectively) and Timed-25 Foot Walk (p<0.05). Each 1% decrease in SIENA was associated with 1.14 point decrease in SDMT score (p=0.03). Each 1% decrease in brain volume SIENA was associated with almost 1.5 letters decrease on LCLA (p=0.02). CONCLUSION: Measures of lesion volume and overall brain volume were associated with different long-term clinical outcome measures in early MS.
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