title: Early magnetic resonance imaging predictors of clinical progression after 48 months in clinically isolated syndrome patients treated with intramuscular interferon β-1a.
abstract: OBJECTIVE
  Our aim was to identify early imaging surrogate markers of clinical progression in patients after the first demyelinating event suggestive of multiple sclerosis treated with weekly intramuscular interferon β-1a. In a prospective observational study, the predictive role of baseline and 6-month changes in magnetic resonance imaging outcomes was investigated with respect to relapse activity and development of confirmed disability progression in patients after 48 months.
  
  
  METHODS
  This study examined 210 patients. Multivariate Cox proportional hazard models were used to analyse predictors of relapse activity and confirmed disability progression after 48 months.
  
  
  RESULTS
  Greater T2 lesion volume [hazard ratio (HR) 1.81; P = 0.005] and the presence of contrast-enhancing lesions (HR 2.13; P < 0.001) at baseline were significantly associated with increased cumulative risk of a second clinical attack over 48 months. A greater decrease of the corpus callosum volume (HR 2.74; P = 0.001) and greater lateral ventricle volume enlargement (HR 2.43; P = 0.002) at 6 months relative to baseline were associated with increased cumulative risk of a second clinical attack between months 6 and 48. In addition, increased risk of confirmed disability progression over 48 months in patients with greater lateral ventricle volume enlargement between baseline and 6 months (HR 4.70; P = 0.001) was detected.
  
  
  CONCLUSIONS
  A greater T2 lesion volume, the presence of contrast-enhancing lesions at baseline, decrease of corpus callosum volume and lateral ventricle volume enlargement over the first 6 months in patients after the first demyelinating event treated with weekly intramuscular interferon β-1a may assist in identification of patients with the highest risk of a second clinical attack and progression of disability.
authors.affiliation: Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic.|Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
authors.forename: T
authors.initials: T
authors.lastname: Uher
authors.affiliation: Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic.
authors.forename: D
authors.initials: D
authors.lastname: Horakova
authors.affiliation: Department of Medicine, Melbourne Brain Centre, University of Melbourne, Melbourne, Australia.|Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Kalincik
authors.affiliation: Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.|IRCCS 'S. Maria Nascente', Don Gnocchi Foundation, Milan, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Bergsland
authors.affiliation: Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Tyblova
authors.affiliation: Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
authors.forename: D P
authors.initials: DP
authors.lastname: Ramasamy
authors.affiliation: Department of Radiology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic.
authors.forename: Z
authors.initials: Z
authors.lastname: Seidl
authors.affiliation: Department of Radiology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Vaneckova
authors.affiliation: Department of Radiology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Krasensky
authors.affiliation: Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic.
authors.forename: E
authors.initials: E
authors.lastname: Havrdova
authors.affiliation: Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.|MR Imaging Clinical Translational Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
authors.forename: R
authors.initials: R
authors.lastname: Zivadinov
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage; D000328:Adult; D015415:Biomarkers; D003711:Demyelinating Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D000068556:Interferon beta-1a / Q000008:administration & dosage; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012008:Recurrence
chemical_list: D000276:Adjuvants, Immunologic; D015415:Biomarkers; D000068556:Interferon beta-1a
keywords: MRI; brain atrophy; clinically isolated syndrome; lesions; multiple sclerosis; predictors