Predicting short-term disability progression in early multiple sclerosis: added value of MRI parameters.
OBJECTIVE
Magnetic resonance imaging (MRI) and clinical parameters are associated with disease progression in multiple sclerosis (MS). The aim of this study was to investigate whether adding MRI parameters to a model with only clinical parameters could improve these associations.


METHODS
89 patients (55 women) with recently diagnosed MS had clinical and MRI evaluation at baseline (time of diagnosis) and at follow-up after 2.2 years. Detailed clinical data were available, including disease type (relapse-onset or progressive-onset) and disability, as measured by the Expanded Disability Status Scale (EDSS). MRI parameters included Normalised Brain Volume (NBV) at baseline, percentage brain volume change (PBVC/year), T2- and T1-lesion loads and spinal cord abnormalities. Progression of disability (increase in EDSS of at least 1 point at follow-up) was the main outcome measure. For a model containing only clinical parameters, the added value of MRI parameters was tested using logistic regression.


RESULTS
PBVC/year and lesion loads at follow-up were significantly higher in the group with progression. Adding PBVC/year to a clinical model improved the model, indicating that MRI parameters added independent information (p<0.001).


CONCLUSIONS
The rate of cerebral atrophy conveys added information for the progression of disability in patients with early MS, suggesting that clinical disability is determined by neurodegenerative changes as depicted by MRI.
Minneboo
A
A
MS Center of the VU University Medical Center, Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands. a.minneboo@vumc.nl
Jasperse
B
B
Barkhof
F
F
Uitdehaag
B M J
BM
Knol
D L
DL
de Groot
V
V
Polman
C H
CH
Castelijns
J A
JA
D000328:Adult; D001284:Atrophy; D001921:Brain / Q000473:pathology; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000175:diagnosis*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis*; D009460:Neurologic Examination; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D013116:Spinal Cord / Q000473:pathology