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Ghione E, Bergsland N, Dwyer MG, Hagemeier J, Jakimovski D, Ramasamy DP, Hojnacki D, Lizarraga AA, Kolb C, Eckert S, Weinstock-Guttman B, Zivadinov R. Disability Improvement Is Associated with Less Brain Atrophy Development in Multiple Sclerosis. AJNR Am J Neuroradiol 2020; 41:1577-1583. [PMID: 32763899 DOI: 10.3174/ajnr.a6684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 06/01/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE It is unknown whether deceleration of brain atrophy is associated with disability improvement in patients with MS. Our aim was to investigate whether patients with MS with disability improvement develop less brain atrophy compared with those who progress in disability or remain stable. MATERIALS AND METHODS We followed 980 patients with MS for a mean of 4.8 ± 2.4 years. Subjects were divided into 3 groups: progress in disability (n = 241, 24.6%), disability improvement (n = 101, 10.3%), and stable (n = 638, 65.1%) at follow-up. Disability improvement and progress in disability were defined on the basis of the Expanded Disability Status Scale score change using standardized guidelines. Stable was defined as nonoccurrence of progress in disability or disability improvement. Normalized whole-brain volume was calculated using SIENAX on 3D T1WI, whereas the lateral ventricle was measured using NeuroSTREAM on 2D-T2-FLAIR images. The percentage brain volume change and percentage lateral ventricle volume change were calculated using SIENA and NeuroSTREAM, respectively. Differences among groups were investigated using ANCOVA, adjusted for age at first MR imaging, race, T2 lesion volume, and corresponding baseline structural volume and the Expanded Disability Status Scale. RESULTS At first MR imaging, there were no differences among progress in disability, disability improvement, and the stable groups in whole-brain volume (P = .71) or lateral ventricle volume (P = .74). During follow-up, patients with disability improvement had the lowest annualized percentage lateral ventricle volume change (1.6% ± 2.7%) followed by patients who were stable (2.1% ± 3.7%) and had progress in disability (4.1% ± 5.5%), respectively (P < .001). The annualized percentage brain volume change values were -0.7% ± 0.7% for disability improvement, -0.8% ± 0.7% for stable, and -1.1% ± 1.1% for progress in disability (P = .001). CONCLUSIONS Patients with MS who improve in their clinical disability develop less brain atrophy across time compared with those who progress.
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Affiliation(s)
- E Ghione
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., D.P.R., R.Z.), Buffalo Neuroimaging Analysis Center
| | - N Bergsland
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., D.P.R., R.Z.), Buffalo Neuroimaging Analysis Center
- IRCCS (N.B.), Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - M G Dwyer
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., D.P.R., R.Z.), Buffalo Neuroimaging Analysis Center
- Center for Biomedical Imaging at the Clinical Translational Science Institute (M.G.D., R.Z.),University at Buffalo, State University of New York, Buffalo, New York
| | - J Hagemeier
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., D.P.R., R.Z.), Buffalo Neuroimaging Analysis Center
| | - D Jakimovski
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., D.P.R., R.Z.), Buffalo Neuroimaging Analysis Center
| | - D P Ramasamy
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., D.P.R., R.Z.), Buffalo Neuroimaging Analysis Center
| | - D Hojnacki
- Department of Neurology (D.H., A.A.L., C.K., S.E., B.W.-G.), Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences
| | - A A Lizarraga
- Department of Neurology (D.H., A.A.L., C.K., S.E., B.W.-G.), Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences
| | - C Kolb
- Department of Neurology (D.H., A.A.L., C.K., S.E., B.W.-G.), Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences
| | - S Eckert
- Department of Neurology (D.H., A.A.L., C.K., S.E., B.W.-G.), Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences
| | - B Weinstock-Guttman
- Department of Neurology (D.H., A.A.L., C.K., S.E., B.W.-G.), Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences
| | - R Zivadinov
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., D.P.R., R.Z.), Buffalo Neuroimaging Analysis Center
- Center for Biomedical Imaging at the Clinical Translational Science Institute (M.G.D., R.Z.),University at Buffalo, State University of New York, Buffalo, New York
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