R Zivadinov1, B Raj2, M Ramanathan3, B Teter4, J Durfee2, M G Dwyer2, N Bergsland5, C Kolb4, D Hojnacki4, R H Benedict4, B Weinstock-Guttman4. 1. From the, Department of Neurology (R.Z., B.R., J.D., M.G.D., N.B.), Buffalo Neuroimaging Analysis Center MR Imaging Clinical Translational Research Center (R.Z.) rzivadinov@bnac.net. 2. From the, Department of Neurology (R.Z., B.R., J.D., M.G.D., N.B.), Buffalo Neuroimaging Analysis Center. 3. Department of Pharmaceutical Sciences (M.R.), School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York. 4. Department of Neurology (B.T., C.K., D.H., R.H.B., B.W.-G.), Jacobs MS Center, University at Buffalo, State University of New York, Buffalo, New York. 5. From the, Department of Neurology (R.Z., B.R., J.D., M.G.D., N.B.), Buffalo Neuroimaging Analysis Center Magnetic Resonance Laboratory (N.B.), IRCCS Don Gnocchi Foundation, Milan, Italy.
Abstract
BACKGROUND AND PURPOSE: The effect of comorbidities on disease severity in MS has not been extensively characterized. We determined the association of comorbidities with MR imaging disease severity outcomes in MS. MATERIALS AND METHODS: Demographic and clinical history of 9 autoimmune comorbidities confirmed by retrospective chart review and quantitative MR imaging data were obtained in 815 patients with MS. The patients were categorized on the basis of the presence/absence of total and specific comorbidities. We analyzed the MR imaging findings, adjusting for key covariates and correcting for multiple comparisons. RESULTS: Two hundred forty-one (29.6%) study subjects presented with comorbidities. Thyroid disease had the highest frequency (n = 97, 11.9%), followed by asthma (n = 41, 5%), type 2 diabetes mellitus (n = 40, 4.9%), psoriasis (n = 33, 4%), and rheumatoid arthritis (n = 22, 2.7%). Patients with MS with comorbidities showed decreased whole-brain and cortical volumes (P < .001), gray matter volume and magnetization transfer ratio of normal-appearing brain tissue (P < .01), and magnetization transfer ratio of gray matter (P < .05). Psoriasis, thyroid disease, and type 2 diabetes mellitus comorbidities were associated with decreased whole-brain, cortical, and gray matter volumes (P < .05). Psoriasis was associated with a decreased magnetization transfer ratio of normal-appearing brain tissue (P < .05), while type 2 diabetes mellitus was associated with increased mean diffusivity (P < .01). CONCLUSIONS: The presence of comorbidities in patients with MS is associated with brain injury on MR imaging. Psoriasis, thyroid disease, and type 2 diabetes mellitus comorbidities were associated with more severe nonconventional MR imaging outcomes.
BACKGROUND AND PURPOSE: The effect of comorbidities on disease severity in MS has not been extensively characterized. We determined the association of comorbidities with MR imaging disease severity outcomes in MS. MATERIALS AND METHODS: Demographic and clinical history of 9 autoimmune comorbidities confirmed by retrospective chart review and quantitative MR imaging data were obtained in 815 patients with MS. The patients were categorized on the basis of the presence/absence of total and specific comorbidities. We analyzed the MR imaging findings, adjusting for key covariates and correcting for multiple comparisons. RESULTS: Two hundred forty-one (29.6%) study subjects presented with comorbidities. Thyroid disease had the highest frequency (n = 97, 11.9%), followed by asthma (n = 41, 5%), type 2 diabetes mellitus (n = 40, 4.9%), psoriasis (n = 33, 4%), and rheumatoid arthritis (n = 22, 2.7%). Patients with MS with comorbidities showed decreased whole-brain and cortical volumes (P < .001), gray matter volume and magnetization transfer ratio of normal-appearing brain tissue (P < .01), and magnetization transfer ratio of gray matter (P < .05). Psoriasis, thyroid disease, and type 2 diabetes mellitus comorbidities were associated with decreased whole-brain, cortical, and gray matter volumes (P < .05). Psoriasis was associated with a decreased magnetization transfer ratio of normal-appearing brain tissue (P < .05), while type 2 diabetes mellitus was associated with increased mean diffusivity (P < .01). CONCLUSIONS: The presence of comorbidities in patients with MS is associated with brain injury on MR imaging. Psoriasis, thyroid disease, and type 2 diabetes mellitus comorbidities were associated with more severe nonconventional MR imaging outcomes.
Authors: C R Simpson; W J A Anderson; P J Helms; M W Taylor; L Watson; G J Prescott; D J Godden; R N Barker Journal: Clin Exp Allergy Date: 2002-01 Impact factor: 5.018
Authors: R Zivadinov; R A Rudick; R De Masi; D Nasuelli; M Ukmar; R S Pozzi-Mucelli; A Grop; G Cazzato; M Zorzon Journal: Neurology Date: 2001-10-09 Impact factor: 9.910
Authors: Robert Zivadinov; Mari Heininen-Brown; Claudiu V Schirda; Guy U Poloni; Niels Bergsland; Christopher R Magnano; Jacqueline Durfee; Cheryl Kennedy; Ellen Carl; Jesper Hagemeier; Ralph H B Benedict; Bianca Weinstock-Guttman; Michael G Dwyer Journal: Neuroimage Date: 2011-07-27 Impact factor: 6.556
Authors: Robert J Fox; David H Miller; J Theodore Phillips; Michael Hutchinson; Eva Havrdova; Mariko Kita; Minhua Yang; Kartik Raghupathi; Mark Novas; Marianne T Sweetser; Vissia Viglietta; Katherine T Dawson Journal: N Engl J Med Date: 2012-09-20 Impact factor: 91.245
Authors: B Weinstock-Guttman; L D Jacobs; C M Brownscheidle; M Baier; D F Rea; B R Apatoff; K M Blitz; P K Coyle; A T Frontera; A D Goodman; M H Gottesman; J Herbert; R Holub; N S Lava; M Lenihan; J Lusins; C Mihai; A E Miller; A B Perel; D H Snyder; R Bakshi; C V Granger; S J Greenberg; B Jubelt; L Krupp; F E Munschauer; D Rubin; S Schwid; J Smiroldo Journal: Mult Scler Date: 2003-06 Impact factor: 6.312
Authors: Chris H Polman; Stephen C Reingold; Gilles Edan; Massimo Filippi; Hans-Peter Hartung; Ludwig Kappos; Fred D Lublin; Luanne M Metz; Henry F McFarland; Paul W O'Connor; Magnhild Sandberg-Wollheim; Alan J Thompson; Brian G Weinshenker; Jerry S Wolinsky Journal: Ann Neurol Date: 2005-12 Impact factor: 10.422
Authors: Ruth Ann Marrie; Nadia Reider; Jeffrey Cohen; Maria Trojano; Per Soelberg Sorensen; Gary Cutter; Stephen Reingold; Olaf Stuve Journal: Mult Scler Date: 2014-12-22 Impact factor: 6.312