title: Clinical and imaging correlates of the multiple sclerosis impact scale in secondary progressive multiple sclerosis.
abstract: The association of pathology and neurological deficit with quality of life (QoL) in multiple sclerosis (MS) is not fully understood. In this study, magnetic resonance imaging (MRI) measures of pathology--T1 and T2 lesion volume and ratio; active T2 lesion number; global and regional brain volume and atrophy; magnetization transfer ratio (MTR) for lesions, normal appearing grey and white matter (NAGM, NAWM); and spinal cord cross-sectional area-and measures of neurological disability (expanded disability status scale, EDSS), deficit (MS functional composite, MSFC) and inflammatory activity (relapse rate) were compared with the MS impact scale (MSIS-29), in participants in a trial of lamotrigine in secondary progressive MS. Data were collected from 118 people (85 female:33 male) aged 30-61 years (mean 50.6 years)--median EDSS 6.0 (range 4.0-7.5); mean disease duration 20.1 years (range 3-41)--at baseline and 2 years. Regression analysis was used to identify independently significant cross-sectional and longitudinal correlates of the physical (MSIS-phys) and psychological (MSIS-psych) components of the MSIS-29; longitudinal analysis using the 57 people in the placebo arm. The only independently significant correlate of MSIS-phys was 1/timed walk (TW) (p < 0.0001, R (2) = 0.13; p = 0.047, R (2) = 0.09); cross-sectionally the best model for MSIS-psych was the paced auditory serial addition test (PASAT-3) (p = 0.041) and T1-to-T2 lesion volume ratio (p = 0.009) (R (2) = 0.13); longitudinally it was change in 1/TW (p = 0.007), mean NAWM MTR (p = 0.003) and NAGM peak height (p = 0.048) (R (2) = 0.32). These data show that MRI measures and clinical measures do impact on quality of life, but the association is limited.
authors.affiliation: Department of Neuroinflammation, Institute of Neurology, Queen Square, London, WC1N 3BG, UK. t.hayton@ion.ucl.ac.uk
authors.forename: T
authors.initials: T
authors.lastname: Hayton
authors.forename: J
authors.initials: J
authors.lastname: Furby
authors.forename: K J
authors.initials: KJ
authors.lastname: Smith
authors.forename: D R
authors.initials: DR
authors.lastname: Altmann
authors.forename: R
authors.initials: R
authors.lastname: Brenner
authors.forename: J
authors.initials: J
authors.lastname: Chataway
authors.forename: K
authors.initials: K
authors.lastname: Hunter
authors.forename: D J
authors.initials: DJ
authors.lastname: Tozer
authors.forename: D H
authors.initials: DH
authors.lastname: Miller
authors.forename: R
authors.initials: R
authors.lastname: Kapoor
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000150:complications* / Q000473:pathology* / Q000523:psychology*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D014227:Triazines / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine