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A Serial 10-Year Follow-Up Study of Atrophied Brain Lesion Volume and Disability Progression in Patients with Relapsing-Remitting MS.
AJNR Am J Neuroradiol 2019; 40(3):446-452AA

Abstract

BACKGROUND AND PURPOSE

Disappearance of T2 lesions into CSF spaces is frequently observed in patients with MS. Our aim was to investigate temporal changes of cumulative atrophied brain T2 lesion volume and 10-year confirmed disability progression.

MATERIALS AND METHODS

We studied 176 patients with relapsing-remitting MS who underwent MR imaging at baseline, 6 months, and then yearly for 10 years. Occurrence of new/enlarging T2 lesions, changes in T2 lesion volume, and whole-brain, cortical and ventricle volumes were assessed yearly between baseline and 10 years. Atrophied T2 lesion volume was calculated by combining baseline lesion masks with follow-up CSF partial volume maps. Ten-year confirmed disability progression was confirmed after 48 weeks. ANCOVA detected MR imaging outcome differences in stable (n = 76) and confirmed disability progression (n = 100) groups at different time points; hierarchic regression determined the unique additive variance explained by atrophied T2 lesion volume regarding the association with confirmed disability progression, in addition to other MR imaging metrics. Cox regression investigated the association of early MR imaging outcome changes and time to development of confirmed disability progression.

RESULTS

The separation of stable-versus-confirmed disability progression groups became significant even in the first 6 months for atrophied T2 lesion volume (140% difference, Cohen d = 0.54, P = .004) and remained significant across all time points (P ≤ .007). The hierarchic model, including all other MR imaging outcomes during 10 years predicting confirmed disability progression, improved significantly after adding atrophied T2 lesion volume (R 2 = 0.27, R 2 change 0.11, P = .009). In Cox regression, atrophied T2 lesion volume in 0-6 months (hazard ratio = 4.23, P = .04) and 0-12 months (hazard ratio = 2.41, P = .022) was the only significant MR imaging predictor of time to confirmed disability progression.

CONCLUSIONS

Atrophied T2 lesion volume is a robust and early marker of disability progression in relapsing-remitting MS.

Authors+Show Affiliations

From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R., M.G.D.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York rzivadinov@bnac.net. Center for Biomedical Imaging at Clinical Translational Research Center (R.Z.), State University of New York, Buffalo, New York.Department of Neurology and Center of Clinical Neuroscience (D.H., T.U., E.H.).From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R., M.G.D.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R., M.G.D.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R., M.G.D.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.Department of Neurology and Center of Clinical Neuroscience (D.H., T.U., E.H.).Department of Radiology (M.V.), First Faculty of Medicine, Charles and General University Hospital in Prague, Prague, Czech Republic.Department of Neurology and Center of Clinical Neuroscience (D.H., T.U., E.H.).From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R., M.G.D.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30819766

Citation

Zivadinov, R, et al. "A Serial 10-Year Follow-Up Study of Atrophied Brain Lesion Volume and Disability Progression in Patients With Relapsing-Remitting MS." AJNR. American Journal of Neuroradiology, vol. 40, no. 3, 2019, pp. 446-452.
Zivadinov R, Horakova D, Bergsland N, et al. A Serial 10-Year Follow-Up Study of Atrophied Brain Lesion Volume and Disability Progression in Patients with Relapsing-Remitting MS. AJNR Am J Neuroradiol. 2019;40(3):446-452.
Zivadinov, R., Horakova, D., Bergsland, N., Hagemeier, J., Ramasamy, D. P., Uher, T., ... Dwyer, M. G. (2019). A Serial 10-Year Follow-Up Study of Atrophied Brain Lesion Volume and Disability Progression in Patients with Relapsing-Remitting MS. AJNR. American Journal of Neuroradiology, 40(3), pp. 446-452. doi:10.3174/ajnr.A5987.
Zivadinov R, et al. A Serial 10-Year Follow-Up Study of Atrophied Brain Lesion Volume and Disability Progression in Patients With Relapsing-Remitting MS. AJNR Am J Neuroradiol. 2019;40(3):446-452. PubMed PMID: 30819766.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Serial 10-Year Follow-Up Study of Atrophied Brain Lesion Volume and Disability Progression in Patients with Relapsing-Remitting MS. AU - Zivadinov,R, AU - Horakova,D, AU - Bergsland,N, AU - Hagemeier,J, AU - Ramasamy,D P, AU - Uher,T, AU - Vaneckova,M, AU - Havrdova,E, AU - Dwyer,M G, Y1 - 2019/02/28/ PY - 2019/01/03/received PY - 2019/01/15/accepted PY - 2019/3/2/pubmed PY - 2019/3/2/medline PY - 2019/3/2/entrez SP - 446 EP - 452 JF - AJNR. American journal of neuroradiology JO - AJNR Am J Neuroradiol VL - 40 IS - 3 N2 - BACKGROUND AND PURPOSE: Disappearance of T2 lesions into CSF spaces is frequently observed in patients with MS. Our aim was to investigate temporal changes of cumulative atrophied brain T2 lesion volume and 10-year confirmed disability progression. MATERIALS AND METHODS: We studied 176 patients with relapsing-remitting MS who underwent MR imaging at baseline, 6 months, and then yearly for 10 years. Occurrence of new/enlarging T2 lesions, changes in T2 lesion volume, and whole-brain, cortical and ventricle volumes were assessed yearly between baseline and 10 years. Atrophied T2 lesion volume was calculated by combining baseline lesion masks with follow-up CSF partial volume maps. Ten-year confirmed disability progression was confirmed after 48 weeks. ANCOVA detected MR imaging outcome differences in stable (n = 76) and confirmed disability progression (n = 100) groups at different time points; hierarchic regression determined the unique additive variance explained by atrophied T2 lesion volume regarding the association with confirmed disability progression, in addition to other MR imaging metrics. Cox regression investigated the association of early MR imaging outcome changes and time to development of confirmed disability progression. RESULTS: The separation of stable-versus-confirmed disability progression groups became significant even in the first 6 months for atrophied T2 lesion volume (140% difference, Cohen d = 0.54, P = .004) and remained significant across all time points (P ≤ .007). The hierarchic model, including all other MR imaging outcomes during 10 years predicting confirmed disability progression, improved significantly after adding atrophied T2 lesion volume (R 2 = 0.27, R 2 change 0.11, P = .009). In Cox regression, atrophied T2 lesion volume in 0-6 months (hazard ratio = 4.23, P = .04) and 0-12 months (hazard ratio = 2.41, P = .022) was the only significant MR imaging predictor of time to confirmed disability progression. CONCLUSIONS: Atrophied T2 lesion volume is a robust and early marker of disability progression in relapsing-remitting MS. SN - 1936-959X UR - https://www.unboundmedicine.com/medline/citation/30819766/A_Serial_10_Year_Follow_Up_Study_of_Atrophied_Brain_Lesion_Volume_and_Disability_Progression_in_Patients_with_Relapsing_Remitting_MS_ L2 - http://www.ajnr.org/cgi/pmidlookup?view=long&pmid=30819766 DB - PRIME DP - Unbound Medicine ER -