title: Voxelwise analysis of conventional magnetic resonance imaging to predict future disability in early relapsing-remitting multiple sclerosis.
abstract: BACKGROUND
  The ability of conventional magnetic resonance imaging (MRI) to predict subsequent physical disability and cognitive deterioration after a clinically isolated syndrome (CIS) is weak.
  
  
  OBJECTIVE
  We aimed to investigate whether conventional MRI changes over 1 year could predict cognitive and physical disability 5 years later in CIS. We performed analyses using a global approach (T(2) lesion load, number of T(2) lesions), but also a topographic approach.
  
  
  METHODS
  This study included 38 patients with a CIS. At inclusion, 10 out of 38 patients fulfilled the 2010 revised McDonald's criteria for the diagnosis of multiple sclerosis. Expanded Disability Status Scale (EDSS) evaluation was performed at baseline, year 1 and year 5, and cognitive evaluation at baseline and year 5. T(2)-weighted MRI was performed at baseline and year 1. We used voxelwise analysis to analyse the predictive value of lesions location for subsequent disability.
  
  
  RESULTS
  Using the global approach, no correlation was found between MRI and clinical data. The occurrence or growth of new lesions in the brainstem was correlated with EDSS changes over the 5 years of follow-up. The occurrence or growth of new lesions in cerebellum, thalami, corpus callosum and frontal lobes over 1 year was correlated with cognitive impairment at 5 years.
  
  
  CONCLUSIONS
  The assessment of lesion location at the first stage of multiple sclerosis may be of value to predict future clinical disability.
authors.affiliation: Aix-Marseille University, CEMEREM, UMR 7339, Marseille, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Wybrecht
authors.forename: Françoise
authors.initials: F
authors.lastname: Reuter
authors.forename: Wafaa
authors.initials: W
authors.lastname: Zaaraoui
authors.forename: Anthony
authors.initials: A
authors.lastname: Faivre
authors.forename: Lydie
authors.initials: L
authors.lastname: Crespy
authors.forename: Audrey
authors.initials: A
authors.lastname: Rico
authors.forename: Irina
authors.initials: I
authors.lastname: Malikova
authors.forename: Sylviane
authors.initials: S
authors.lastname: Confort-Gouny
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Soulier
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Cozzone
authors.forename: Jean
authors.initials: J
authors.lastname: Pelletier
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Ranjeva
authors.forename: Bertrand
authors.initials: B
authors.lastname: Audoin
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D003071:Cognition; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult