Michael G Dwyer1, Niels Bergsland1, Deepa P Ramasamy1, Dejan Jakimovski1, Bianca Weinstock-Guttman2, Robert Zivadinov3. 1. Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY. 2. Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY. 3. Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York, Buffalo, NY.
Abstract
BACKGROUND AND PURPOSE: Lesion accrual in multiple sclerosis (MS) is an important and clinically relevant measure, used extensively as an imaging trial endpoint. However, lesions may also shrink or disappear entirely due to atrophy. Although generally ignored or treated as a nuisance, this phenomenon may actually be an important stand-alone imaging biomarker. Therefore, we investigated the rate of brain lesion loss due to atrophy (atrophied lesion volume) in MS subtypes compared to baseline lesion volume and to new and enlarging lesion volumes, and evaluated the independent predictive value of this phenomenon for clinical disability. METHODS: A total of 192 patients (18 clinically isolated syndrome, 126 relapsing-remitting MS, and 48 progressive) received 3T magnetic resonance imaging at baseline and 5 years. Lesions were quantified at baseline, and new/enlarging lesion volumes were calculated over the study interval. Atrophied lesion volume was calculated by combining baseline lesion masks with follow-up SIENAX-derived cerebrospinal fluid partial volume maps. Measures were compared between disease subgroups, and correlations with disability change (Expanded Disability Status Scale [EDSS]) were evaluated. Hierarchical regression was employed to determine the unique additive value of atrophied lesion volume. RESULTS: Atrophied lesion volume was different between MS subtypes (P = .02), and exceeded new lesion volume accumulation in progressive MS (298.1 vs. 75.5 mm3 ). Atrophied lesion volume was the only significant correlate of EDSS change (r = .192 relapsing, r = .317 progressive, P < .05), and explained significant additional variance when controlling for brain atrophy and new/enlarging lesion volume (R2 .092 vs. .045, P = .003). CONCLUSION: Atrophied lesion volume is a unique and clinically relevant imaging marker in MS, with particular promise in progressive MS.
BACKGROUND AND PURPOSE:Lesion accrual in multiple sclerosis (MS) is an important and clinically relevant measure, used extensively as an imaging trial endpoint. However, lesions may also shrink or disappear entirely due to atrophy. Although generally ignored or treated as a nuisance, this phenomenon may actually be an important stand-alone imaging biomarker. Therefore, we investigated the rate of brain lesion loss due to atrophy (atrophied lesion volume) in MS subtypes compared to baseline lesion volume and to new and enlarging lesion volumes, and evaluated the independent predictive value of this phenomenon for clinical disability. METHODS: A total of 192 patients (18 clinically isolated syndrome, 126 relapsing-remitting MS, and 48 progressive) received 3T magnetic resonance imaging at baseline and 5 years. Lesions were quantified at baseline, and new/enlarging lesion volumes were calculated over the study interval. Atrophied lesion volume was calculated by combining baseline lesion masks with follow-up SIENAX-derived cerebrospinal fluid partial volume maps. Measures were compared between disease subgroups, and correlations with disability change (Expanded Disability Status Scale [EDSS]) were evaluated. Hierarchical regression was employed to determine the unique additive value of atrophied lesion volume. RESULTS:Atrophied lesion volume was different between MS subtypes (P = .02), and exceeded new lesion volume accumulation in progressive MS (298.1 vs. 75.5 mm3 ). Atrophied lesion volume was the only significant correlate of EDSS change (r = .192 relapsing, r = .317 progressive, P < .05), and explained significant additional variance when controlling for brain atrophy and new/enlarging lesion volume (R2 .092 vs. .045, P = .003). CONCLUSION:Atrophied lesion volume is a unique and clinically relevant imaging marker in MS, with particular promise in progressive MS.
Authors: Corey W Bown; Omair A Khan; Elizabeth E Moore; Dandan Liu; Kimberly R Pechman; Francis E Cambronero; James G Terry; Sangeeta Nair; L Taylor Davis; Katherine A Gifford; Bennett A Landman; Timothy J Hohman; John Jeffrey Carr; Angela L Jefferson Journal: Arterioscler Thromb Vasc Biol Date: 2021-10-28 Impact factor: 8.311
Authors: Dejan Jakimovski; Niels Bergsland; Michael G Dwyer; Jesper Hagemeier; Deepa P Ramasamy; Kinga Szigeti; Thomas Guttuso; David Lichter; David Hojnacki; Bianca Weinstock-Guttman; Ralph H B Benedict; Robert Zivadinov Journal: Neurobiol Aging Date: 2020-02-08 Impact factor: 4.673
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Authors: Angela C C Jochems; Susana Muñoz Maniega; Maria Del C Valdés Hernández; Gayle Barclay; Devasuda Anblagan; Lucia Ballerini; Rozanna Meijboom; Stewart Wiseman; Adele M Taylor; Janie Corley; Francesca M Chappell; Ellen V Backhouse; Michael S Stringer; David Alexander Dickie; Mark E Bastin; Ian J Deary; Simon R Cox; Joanna M Wardlaw Journal: Neuroimage Clin Date: 2022-04-26 Impact factor: 4.891