title: Brain MRI lesions and atrophy are associated with employment status in patients with multiple sclerosis.
abstract: Multiple sclerosis (MS) commonly affects occupational function. We investigated the link between brain MRI and employment status. Patients with MS (n = 100) completed a Work Productivity and Activity Impairment (WPAI) (general health version) survey measuring employment status, absenteeism, presenteeism, and overall work and daily activity impairment. Patients "working for pay" were considered employed; "temporarily not working but looking for work," "not working or looking for work due to age," and "not working or looking for work due to disability" were considered not employed. Brain MRI T1 hypointense (T1LV) and T2 hyperintense (T2LV) lesion volumes were quantified. To assess lesional destructive capability, we calculated each subject's ratio of T1LV to T2LV (T1/T2). Normalized brain parenchymal volume (BPV) assessed brain atrophy. The mean (SD) age was 45.5 (9.7) years; disease duration was 12.1 (8.1) years; 75 % were women, 76 % were relapsing-remitting, and 76 % were employed. T1LV, T1/T2, Expanded Disability Status Scale (EDSS) scores, and activity impairment were lower and BPV was higher in the employed vs. not employed group (Wilcoxon tests, p < 0.05). Age, disease duration, MS clinical subtype, and T2LV did not differ between groups (p > 0.05). In multivariable logistic regression modeling, adjusting for age, sex, and disease duration, higher T1LV predicted a lower chance of employment (p < 0.05). Pearson correlations showed that EDSS was associated with activity impairment (p < 0.05). Disease duration, age, and MRI measures were not correlated with activity impairment or other WPAI outcomes (p > 0.05). We report a link between brain atrophy and lesions, particularly lesions with destructive potential, to MS employment status.
authors.affiliation: Laboratory for Neuroimaging Research, Department of Neurology, Partners MS Center, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Shahamat
authors.initials: S
authors.lastname: Tauhid
authors.affiliation: Laboratory for Neuroimaging Research, Department of Neurology, Partners MS Center, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Renxin
authors.initials: R
authors.lastname: Chu
authors.affiliation: Novartis Pharmaceuticals, East Hanover, NJ, USA.
authors.forename: Rahul
authors.initials: R
authors.lastname: Sasane
authors.affiliation: Laboratory for Neuroimaging Research, Department of Neurology, Partners MS Center, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Bonnie I
authors.initials: BI
authors.lastname: Glanz
authors.affiliation: Laboratory for Neuroimaging Research, Department of Neurology, Partners MS Center, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Mohit
authors.initials: M
authors.lastname: Neema
authors.affiliation: Laboratory for Neuroimaging Research, Department of Neurology, Partners MS Center, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Miller
authors.affiliation: Laboratory for Neuroimaging Research, Department of Neurology, Partners MS Center, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Gloria
authors.initials: G
authors.lastname: Kim
authors.affiliation: Analysis Group, Inc., Boston, MA, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Signorovitch
authors.affiliation: Laboratory for Neuroimaging Research, Department of Neurology, Partners MS Center, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Healy
authors.affiliation: Laboratory for Neuroimaging Research, Department of Neurology, Partners MS Center, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Tanuja
authors.initials: T
authors.lastname: Chitnis
authors.affiliation: Laboratory for Neuroimaging Research, Department of Neurology, Partners MS Center, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Howard L
authors.initials: HL
authors.lastname: Weiner
authors.affiliation: Laboratory for Neuroimaging Research, Department of Neurology, Partners MS Center, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA. rbakshi@post.harvard.edu.|Laboratory for Neuroimaging Research, Department of Radiology, Partners MS Center, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA. rbakshi@post.harvard.edu.|Laboratory for Neuroimaging Research, One Brookline Place, Brookline, MA, 02445, USA. rbakshi@post.harvard.edu.
authors.forename: Rohit
authors.initials: R
authors.lastname: Bakshi
mesh_terms: D000328:Adult; D001284:Atrophy / Q000473:pathology; D001921:Brain / Q000473:pathology*; D004185:Disability Evaluation; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology* / Q000503:physiopathology*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000473:pathology / Q000503:physiopathology; D012720:Severity of Illness Index
keywords: Brain atrophy; Brain lesions; Disability; Employment; MRI; Multiple sclerosis; Productivity