Brain volume and diffusion markers on MRI predict disease progression

Epub ahead of printSämann et al. Brain Volume and Diffusion Markers as Predictors of Disability and Short-Term Disease Evolution in Multiple Sclerosis. AJNR Am J Neuroradiol. 2012 Mar 1. 

"This study shows that an MRI marker of structural integrity can predict disability progression in MS'ers in the future. This implies that MS'ers with damage are more likely to progress in the future; i.e. damage be-gets damage. This supports many other clinical and MRI studies in MS. MS'ers who already have acquired damage, clinically or sub-clinically on MRI, are the ones who will progress more in the future."

BACKGROUND AND PURPOSE: MRI markers of neuronal and axonal damage in MS have emerged as critical long-term predictors of MS-related disability. Here the researchers investigated the potential of whole-brain diffusivity (" a big term for a marker of structural integrity of the brain") and brain volume ("a gross marker of nerve cell bulk") for the prediction of disability and short- to medium-term clinical evolution.

MATERIALS AND METHODS: 54 patients with MS (87% under immunomodulatory therapy, baseline and follow-up at a median of 12 months).

RESULTS: At both time points, ADC (diffusivity) histogram analysis provided robust predictors of the MS functional composite scores (R-squared = 0.58, P < .001)*, incorporated cognition and fine-motor skill subscores, and EDSS scores. 

* "R-squared of 0.58 means that 58% of the change of the MSFC can be explained by the changes in the ADC histogram; this is a very impressive correlation. As a doubting Thomas I would need to see this study reproduced."



CONCLUSIONS: Diffusion histogram analysis provided stable surrogates of disability in MS and proved sensitive for monitoring disease progression during a median of 12 months. Advanced neuroaxonal pathology at baseline was indicative of an increased risk for sustained progression during a median of 12 months, independent of intercurrent relapses.

Labels: , ,