title: Magnetic resonance imaging correlates of clinical outcomes in early multiple sclerosis.
abstract: OBJECTIVE
  To study the association between changes in brain magnetic resonance imaging (MRI) and clinical outcomes in early MS.
  
  
  METHODS
  MS patients within 12 months of onset were enrolled and followed up to 3 years. Clinical measures included Symbol Digit Modalities Test (SDMT), MS Functional Composite (MSFC) and low contrast letter acuity (LCLA). MRI outcomes included brain volume changes measured by SIENA and SIENAX normalized measurements [brain parenchymal volume (BPV), normal-appearing white and gray matter volume (NAWMV and GMV) and T2 lesion volume (T2LV)]. Mixed model regression measured time trends and associations between imaging and clinical outcome.
  
  
  RESULTS
  Forty-three patients were enrolled within 7.5±4.9 months of onset. Baseline T2 lesion volume predicted subsequent changes in Paced Auditory Serial Addition Test (PASAT) (p=0.004), whereas baseline measures of atrophy including BPV, GMV, and NAWMV predicted longitudinal changes in MSFC (p=0.016, p=0.040, p=0.021, respectively) and Timed-25 Foot Walk (p<0.05). Each 1% decrease in SIENA was associated with 1.14 point decrease in SDMT score (p=0.03). Each 1% decrease in brain volume SIENA was associated with almost 1.5 letters decrease on LCLA (p=0.02).
  
  
  CONCLUSIONS
  Measures of lesion volume and overall brain volume were associated with different long-term clinical outcome measures in early MS.
authors.affiliation: Departments of Neurology, University of California San Francisco, San Francisco, CA, United States. Electronic address: hadi.maghzi@gmail.com.
authors.forename: Amir-Hadi
authors.initials: AH
authors.lastname: Maghzi
authors.affiliation: Departments of Neurology, University of California San Francisco, San Francisco, CA, United States.
authors.forename: Nisha
authors.initials: N
authors.lastname: Revirajan
authors.affiliation: Departments of Internal Medicine, University of California San Francisco, San Francisco, CA, United States.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Julian
authors.affiliation: Department of Neurology, Oregon Health and Science University, OR, United States.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Spain
authors.affiliation: Department of Neurology, Johns Hopkins University, Baltimore, MD, United States.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Mowry
authors.affiliation: Department of Neurology, Yale school of medicine, New Haven, CT, United States.
authors.forename: Shuang
authors.initials: S
authors.lastname: Liu
authors.affiliation: Departments of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States.
authors.forename: Chengshi
authors.initials: C
authors.lastname: Jin
authors.affiliation: Departments of Neurology, University of California San Francisco, San Francisco, CA, United States.
authors.forename: Ari J
authors.initials: AJ
authors.lastname: Green
authors.affiliation: Departments of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States.
authors.forename: Charles E
authors.initials: CE
authors.lastname: McCulloch
authors.affiliation: Department of Neurology, Yale school of medicine, New Haven, CT, United States.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pelletier
authors.affiliation: Departments of Neurology, University of California San Francisco, San Francisco, CA, United States; Departments of Pediatrics, University of California San Francisco, San Francisco, CA, United States.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Waubant
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage; D000328:Adult; D001921:Brain / Q000187:drug effects / Q000473:pathology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D000068556:Interferon beta-1a; D016899:Interferon-beta / Q000008:administration & dosage; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology*; D018696:Neuroprotective Agents / Q000627:therapeutic use; D009929:Organ Size; D012044:Regression Analysis; D019782:Riluzole / Q000627:therapeutic use; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000276:Adjuvants, Immunologic; D018696:Neuroprotective Agents; D016899:Interferon-beta; D019782:Riluzole; D000068556:Interferon beta-1a
keywords: Brain atrophy; Cognition; Magnetic resonance imaging; Multiple sclerosis; Neuroprotection; Outcomes