Magnetic resonance disease severity scale (MRDSS) for patients with multiple sclerosis: a longitudinal study.
BACKGROUND
We previously described a composite MRI scale combining T1-lesions, T2-lesions and whole brain atrophy in multiple sclerosis (MS): the magnetic resonance disease severity scale (MRDSS).


OBJECTIVE
Test strength of the MRDSS vs. individual MRI measures for sensitivity to longitudinal change.


METHODS
We studied 84 MS patients over a 3.2±0.3 year follow-up. Baseline and follow-up T2-lesion volume (T2LV), T1-hypointense lesion volume (T1LV), and brain parenchymal fraction (BPF) were measured. MRDSS was the combination of standardized T2LV, T1/T2 ratio and BPF.


RESULTS
Patients had higher MRDSS at follow-up vs. baseline (p<0.001). BPF decreased (p<0.001), T1/T2 increased (p<0.001), and T2LV was unchanged (p>0.5). Change in MRDSS was larger than the change in MRI subcomponents. While MRDSS showed significant change in relapsing-remitting (RR) (p<0.001) and secondary progressive (SP) phenotypes (p<0.05), BPF and T1/T2 ratio changed only in RRMS (p<0.001). Longitudinal change in MRDSS was significantly different between RRMS and SPMS (p=0.0027); however, change in the individual MRI components did not differ. Evaluation with respect to predicting on-study clinical worsening as measured by EDSS revealed a significant association only for T2LV (p=0.038).


CONCLUSIONS
Results suggest improved sensitivity of MRDSS to longitudinal change vs. individual MRI measures. MRDSS has particularly high sensitivity in RRMS.
Department of Neurology, University of Massachusetts, Boston, MA, USA.
Jennifer
J
Moodie
Brian C
BC
Healy
Guy J
GJ
Buckle
Susan A
SA
Gauthier
Bonnie I
BI
Glanz
Ashish
A
Arora
Antonia
A
Ceccarelli
Shahamat
S
Tauhid
Xue-Mei
XM
Han
Arun
A
Venkataraman
Tanuja
T
Chitnis
Samia J
SJ
Khoury
Charles R G
CR
Guttmann
Howard L
HL
Weiner
Mohit
M
Neema
Rohit
R
Bakshi
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology / Q000473:pathology*; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index