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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: Rocca, Maria Assunta (Author) , Valsasina, Paola (Author) , Meani, Alessandro (Author) , Gobbi, Claudio (Author) , Zecca, Chiara (Author) , Barkhof, Frederik (Author) , Schoonheim, Menno M. (Author) , Strijbis, Eva M. (Author) , Vrenken, Hugo (Author) , Gallo, Antonio (Author) , Bisecco, Alvino (Author) , Ciccarelli, Olga (Author) , Yiannakas, Marios (Author) , Rovira, Alex (Author) , Sastre-Garriga, Jaume (Author) , Palace, Jacqueline (Author) , Matthews, Lucy (Author) , Gass, Achim (Author) , Eisele, Philipp (Author) , Lukas, Carsten (Author) , Bellenberg, Barbara (Author) , Margoni, Monica (Author) , Preziosa, Paolo (Author) , Filippi, Massimo (Author)
Format: Article (Journal)
Language:English
Published: 2023
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

MARC

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245 1 0 |a Spinal cord lesions and brain grey matter atrophy independently predict clinical worsening in definite multiple sclerosis  |b a 5-year, multicentre study : multiple sclerosis : original research  |c 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 
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520 |a 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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