title: Gray matter atrophy and disability progression in patients with early relapsing-remitting multiple sclerosis: a 5-year longitudinal study.
abstract: 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.
authors.affiliation: Department of Neurology, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic. dana.horak@post.cz
authors.forename: Dana
authors.initials: D
authors.lastname: Horakova
authors.forename: Michael G
authors.initials: MG
authors.lastname: Dwyer
authors.forename: Eva
authors.initials: E
authors.lastname: Havrdova
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Cox
authors.forename: Ondrej
authors.initials: O
authors.lastname: Dolezal
authors.forename: Niels
authors.initials: N
authors.lastname: Bergsland
authors.forename: Brett
authors.initials: B
authors.lastname: Rimes
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Seidl
authors.forename: Manuela
authors.initials: M
authors.lastname: Vaneckova
authors.forename: Robert
authors.initials: R
authors.lastname: Zivadinov
mesh_terms: 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
chemical_list: D016899:Interferon-beta; D001379:Azathioprine; D011241:Prednisone; D000068556:Interferon beta-1a