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T2 lesion location really matters: a 10 year follow-up study in primary progressive multiple sclerosis

Bodini, B.; Battaglini, M.; De Stefano, N.; Khaleeli, Z.; Barkhof, F.; Chard, D.; Filippi, M.; ... Ciccarelli, O.; + view all (2011) T2 lesion location really matters: a 10 year follow-up study in primary progressive multiple sclerosis. Journal of Neurology Neurosurgery and Psychiatry , 82 (1) pp. 72-77. 10.1136/jnnp.2009.201574. Green open access

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Abstract

Objectives: Prediction of long term clinical outcome in patients with primary progressive multiple sclerosis (PPMS) using imaging has important clinical implications, but remains challenging. We aimed to determine whether spatial location of T2 and T1 brain lesions predicts clinical progression during a 10-year follow-up in PPMS. Methods: Lesion probability maps of the T2 and T1 brain lesions were generated using the baseline scans of 80 patients with PPMS who were clinically assessed at baseline and then after 1, 2, 5 and 10 years. For each patient, the time (in years) taken before bilateral support was required to walk (time to event (TTE)) was used as a measure of progression rate. The probability of each voxel being ‘lesional’ was correlated with TTE, adjusting for age, gender, disease duration, centre and spinal cord cross sectional area, using a multiple linear regression model. To identify the best, independent predictor of progression, a Cox regression model was used. Results: A significant correlation between a shorter TTE and a higher probability of a voxel being lesional on T2 scans was found in the bilateral corticospinal tract and superior longitudinal fasciculus, and in the right inferior fronto-occipital fasciculus (p<0.05). The best predictor of progression rate was the T2 lesion load measured along the right inferior fronto-occipital fasciculus (p=0.016, hazard ratio 1.00652, 95% CI 1.00121 to 1.01186). Conclusion: Our results suggest that the location of T2 brain lesions in the motor and associative tracts is an important contributor to the progression of disability in PPMS, and is independent of spinal cord involvement.

Type: Article
Title: T2 lesion location really matters: a 10 year follow-up study in primary progressive multiple sclerosis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/jnnp.2009.201574
Publisher version: http://dx.doi.org/10.1136/jnnp.2009.201574
Language: English
Additional information: Copyright The Authors 2010. Produced by BMJ Publishing Group Ltd under licence. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neuroinflammation
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
URI: https://discovery.ucl.ac.uk/id/eprint/20028
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