Spinal cord lesions and brain grey matter atrophy independently predict clinical worsening in definite multiple sclerosis: a 5-year, multicentre study : multiple sclerosis : original research
Objectives To evaluate the combined contribution of brain and cervical cord damage in predicting 5-year clinical worsening in a multicentre cohort of definite multiple sclerosis (MS) patients. Methods Baseline 3.0T brain and cervical cord T2-weighted and three-dimensional T1-weighted MRI was acquire...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2023
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| In: |
Journal of neurology, neurosurgery, and psychiatry
Year: 2023, Volume: 94, Issue: 1, Pages: 10-18 |
| ISSN: | 1468-330X |
| DOI: | 10.1136/jnnp-2022-329854 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1136/jnnp-2022-329854 Verlag, kostenfrei, Volltext: http://jnnp.bmj.com/content/94/1/10 
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| Author Notes: | Maria A Rocca, Paola Valsasina, Alessandro Meani, Claudio Gobbi, Chiara Zecca, Frederik Barkhof, Menno M Schoonheim, Eva M Strijbis, Hugo Vrenken, Antonio Gallo, Alvino Bisecco, Olga Ciccarelli, Marios Yiannakas, Alex Rovira, Jaume Sastre-Garriga, Jacqueline Palace, Lucy Matthews, Achim Gass, Philipp Eisele, Carsten Lukas, Barbara Bellenberg, Monica Margoni, Paolo Preziosa, Massimo Filippi, on behalf of MAGNIMS study group |
| Summary: | Objectives To evaluate the combined contribution of brain and cervical cord damage in predicting 5-year clinical worsening in a multicentre cohort of definite multiple sclerosis (MS) patients. Methods Baseline 3.0T brain and cervical cord T2-weighted and three-dimensional T1-weighted MRI was acquired in 367 patients with MS (326 relapse-onset and 41 progressive-onset) and 179 healthy controls. Expanded Disability Status Scale (EDSS) score was obtained at baseline and after a median follow-up of 5.1 years (IQR=4.8-5.2). At follow-up, patients were classified as clinically stable/worsened according to EDSS changes. Generalised linear mixed models identified predictors of clinical worsening, evolution to secondary progressive (SP) MS and reaching EDSS=3.0, 4.0 and 6.0 milestones at 5 years. Results At follow-up, 120/367 (33%) patients with MS worsened clinically; 36/256 (14%) patients with relapsing-remitting evolved to SPMS. Baseline predictors of EDSS worsening were progressive-onset versus relapse-onset MS (standardised beta (beta)=0.97), higher EDSS (beta=0.41), higher cord lesion number (beta=0.41), lower normalised cortical volume (beta=-0.15) and lower cord area (beta=-0.28) (C-index=0.81). Older age (beta=0.86), higher EDSS (beta=1.40) and cord lesion number (beta=0.87) independently predicted SPMS conversion (C-index=0.91). Predictors of reaching EDSS=3.0 after 5 years were higher baseline EDSS (beta=1.49), cord lesion number (beta=1.02) and lower normalised cortical volume (beta=-0.56) (C-index=0.88). Baseline age (beta=0.30), higher EDSS (beta=2.03), higher cord lesion number (beta=0.66) and lower cord area (beta=-0.41) predicted EDSS=4.0 (C-index=0.92). Finally, higher baseline EDSS (beta=1.87) and cord lesion number (beta=0.54) predicted EDSS=6.0 (C-index=0.91). Conclusions Spinal cord damage and, to a lesser extent, cortical volume loss helped predicting worse 5-year clinical outcomes in MS. |
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| Item Description: | Online veröffentlicht: 28. September 2022 Gesehen am 09.05.2023 |
| Physical Description: | Online Resource |
| ISSN: | 1468-330X |
| DOI: | 10.1136/jnnp-2022-329854 |