Related Experiment Videos
Optimizing the association between disability and biological markers in MS
N F Kalkers1, E Bergers, J A Castelijns
1MS-MRI Center, VU Medical Center, Amsterdam, the Netherlands. nf.kalkers@azvu.nl
Objective:
Axonal damage is an important feature of MS pathology and the likely substrate of development of progressive disability. Brain volume measurement on MRI can be used as an overall marker of tissue damage and axonal loss. The authors studied the relation of brain volume measurements with the MS Functional Composite (MSFC) in an attempt to improve the clinico-radiologic association.
Methods:
In 137 patients with MS (80 relapsing-remitting [RR], 36 secondary progressive [SP], and 21 primary progressive [PP]) and 12 healthy controls, a brain MRI scan was obtained. Patients also underwent MSFC and Expanded Disability Status Scale (EDSS) assessments. MRI analysis included determination of hypointense T1- and hyperintense T2-weighted lesion load, and two brain volume measurements: 1) the parenchymal fraction (PF): whole brain parenchyma/intracranial volume; and 2) the ventricular fraction (VF): ventricular volume/whole brain parenchyma.
Results:
The median PF was smaller and the median VF larger in the patient group (0.81 for PF and 0.029 for VF) than in the control group (0.87 for PF, p < 0.001; and 0.013 for VF, p < 0.01). For the patient population, moderate correlations were found between brain volume measurements and MSFC (0.36 for PF and -0.40 for VF). Patients with short disease duration showed a correlation of MSFC with both brain and lesion volume measurements on MRI, whereas patients with long disease duration only showed a correlation with brain volume measurements.
Conclusion:
Brain volume measurements are correlated with disability as assessed by the MSFC. Although in the early phase of the disease the amount of focal demyelination is important, the residual brain volume seems to be more relevant in determining disability in later phases of the disease.
Insights
Brain volume measurements on MRI correlate with disability in multiple sclerosis (MS) patients. While early MS disability is linked to lesions, later disability is more associated with overall brain volume loss.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Axonal damage is a key feature of multiple sclerosis (MS) pathology, contributing to progressive disability.
- Brain volume measurement via MRI serves as a marker for tissue damage and axonal loss in MS.
Purpose of the Study:
- To investigate the relationship between brain volume measurements and the MS Functional Composite (MSFC).
- To enhance the clinico-radiologic association in multiple sclerosis research.
Main Methods:
- 137 MS patients and 12 healthy controls underwent MRI scans.
- Brain MRI analysis included T1/T2 lesion load, parenchymal fraction (PF), and ventricular fraction (VF).
- Patients also completed MSFC and Expanded Disability Status Scale (EDSS) assessments.
Main Results:
- MS patients exhibited smaller PF and larger VF compared to controls (p < 0.001 for PF, p < 0.01 for VF).
- Moderate correlations were observed between brain volume metrics (PF, VF) and MSFC scores in patients.
- Early MS showed correlations with both brain and lesion volume, while late MS correlated only with brain volume.
Conclusions:
- Brain volume measurements are significantly correlated with MS patient disability, as measured by MSFC.
- In early MS, focal demyelination is crucial, but in later stages, residual brain volume is a more critical determinant of disability.