Gray matter atrophy and disability progression in patients with early relapsing-remitting multiple sclerosis: a 5-year longitudinal study.
We assessed the relationship between gray matter (GM) and white matter (WM) atrophy and clinical status in early relapsing-remitting multiple sclerosis (MS) patients over 5 years. A group of 181 patients who participated in the ASA (Avonex-Steroid-Azathioprine) study and had complete clinical and MRI assessments over 2 and 5 years was investigated. One hundred seventy (170) patients completed the 12-month follow-up, 147 the 24-month, 98 the 36-month, 65 the 48-month and 47 the 60-month. Changes in GM (GMV), WM (WMV) and peripheral GM (PGV) volumes, whole brain volume (percentage brain volume change PBVC), lateral ventricle volume (LVV), third ventricle width (3VW) and T2-lesion volume (T2-LV) were measured. Patients were assigned according to their clinical status to one of two groups: the Stable group, and the Reached Confirmed Sustained Progression (RCSP) group (24-week interval). At 0-6 months PBVC and GMV, at 0-12 months PBVC, GMV and T2-LV, at 0-24 months PBVC and GMV, at 0-36 months PBVC, GMV and T2-LV, and at 0-48 PBVC predicted the differences between the RCSP and Stable groups. PBVC and LVV showed the strongest ability to differentiate patients who presented 0 or >or=3 relapses in the Stable group. Decline in PBVC and GMV were predictive markers of disability deterioration. Correlation of T2-LV with clinical status was weaker and decreased over time. Higher number of relapses was associated with faster decline in whole brain volume.
Horakova
Dana
D
Department of Neurology, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic. dana.horak@post.cz
Dwyer
Michael G
MG
Havrdova
Eva
E
Cox
Jennifer L
JL
Dolezal
Ondrej
O
Bergsland
Niels
N
Rimes
Brett
B
Seidl
Zdenek
Z
Vaneckova
Manuela
M
Zivadinov
Robert
R
D000328:Adult; D001284:Atrophy / Q000473:pathology; D001379:Azathioprine / Q000627:therapeutic use; D001921:Brain / Q000473:pathology*; D002552:Cerebral Ventricles / Q000473:pathology; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000068556:Interferon beta-1a; D016899:Interferon-beta / Q000627:therapeutic use; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D012008:Recurrence
D016899:Interferon-beta; D001379:Azathioprine; D011241:Prednisone; D000068556:Interferon beta-1a