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The evolving contribution of MRI measures towards the prediction of secondary progressive multiple sclerosis

Ananthavarathan, Piriyankan; Sahi, Nitin; Chung, Karen; Haider, Lukas; Prados, Ferran; Trip, S Anand; Ciccarelli, Olga; ... Chard, Declan T; + view all (2024) The evolving contribution of MRI measures towards the prediction of secondary progressive multiple sclerosis. Journal of Neurology, Neurosurgery and Psychiatry 10.1136/jnnp-2024-333917. Green open access

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Abstract

BACKGROUND: In multiple sclerosis (MS), both lesion accrual and brain atrophy predict clinical outcomes. However, it is unclear whether these prognostic features are equally relevant throughout the course of MS. Among 103 participants recruited following a clinically isolated syndrome (CIS) and followed up over 30 years, we explored (1) whether white matter lesions were prognostically more relevant earlier and brain atrophy later in the disease course towards development of secondary progressive (SP) disease; (2) if so, when the balance in prognostic contribution shifts and (3) whether optimised prognostic models predicting SP disease should include different features dependent on disease duration. METHODS: Binary logistic regression models were built using age, gender, brain lesion counts and locations, and linear atrophy measures (third ventricular width and medullary width) at each time point up to 20 years, using either single time point data alone or adjusted for baseline measures. RESULTS: By 30 years, 27 participants remained CIS while 60 had MS (26 SPMS and 16 MS-related death). Lesions counts were prognostically significant from baseline and at all later time points while linear atrophy measure models reached significance from 5 years. When adjusted for baseline, in combined MRI models including lesion count and linear atrophy measures, only lesion counts were significant predictors. In combined models including relapse measures, Expanded Disability Status Scale scores and MRI measures, only infratentorial lesions were significant predictors throughout. CONCLUSIONS: While SPMS progression is associated with brain atrophy, in predictive models only infratentorial lesions were consistently prognostically significant.

Type: Article
Title: The evolving contribution of MRI measures towards the prediction of secondary progressive multiple sclerosis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/jnnp-2024-333917
Publisher version: http://doi.org/10.1136/jnnp-2024-333917
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Multiple sclerosis, neurodegeneration, inflammation, pathogenesis, clinical outcomes, predictive models
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Brain Repair and Rehabilitation
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neuroinflammation
URI: https://discovery.ucl.ac.uk/id/eprint/10195419
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