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An expanded composite scale of MRI-defined disease severity in multiple sclerosis: MRDSS2
Rohit Bakshi1, Mohit Neema, Shahamat Tauhid
1aDepartment of Neurology bDepartment of Radiology cLaboratory for Neuroimaging Research, Brigham and Women's Hospital dPartners Multiple Sclerosis Center, Harvard Medical School, Boston, Massachusetts, USA.
The new Magnetic Resonance Disease Severity Scale 2 (MRDSS2) effectively models physical disability and cognitive status in multiple sclerosis (MS) by integrating brain and spinal cord MRI measures. This advanced scale shows strong correlations with clinical outcomes, improving MS assessment.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Multiple Sclerosis (MS) assessment relies on clinical measures, but MRI can provide objective insights into disease burden.
- Existing MRI scales may not fully capture the complexity of MS pathology, including both brain and spinal cord involvement.
Purpose of the Study:
- To evaluate a novel Magnetic Resonance Disease Severity Scale version 2 (MRDSS2) that incorporates cerebral gray matter (GM) and spinal cord metrics from 3T MRI.
- To model the relationship between MRI findings and physical disability or cognitive status in MS patients.
Main Methods:
- Fifty-five MS patients and 30 controls underwent high-resolution 3T MRI.
- MRDSS2 was calculated using normalized GM fraction (GMF), T2 lesion volume (T2LV), T1/T2 ratio, and upper cervical spinal cord area (UCCA).
- Correlations between MRDSS2 components and physical disability (Expanded Disability Status Scale) and cognitive function (Minimal Assessment of Cognitive Function in MS) were analyzed.
Main Results:
- MRDSS2 showed significant correlations with physical disability (r=0.33, P=0.013), primarily driven by spinal cord involvement (UCCA).
- MRDSS2 demonstrated a larger effect size for cognitive status differences (P=0.035) compared to individual components, influenced by cerebral lesions (T1/T2) and atrophy (GMF).
- The new scale integrates brain and spinal cord measures for a more comprehensive assessment.
Conclusions:
- MRDSS2, incorporating cerebral GM and spinal cord measures, offers improved concurrent validity with clinical status in MS.
- This enhanced MRI scale provides a more comprehensive assessment of MS-related physical disability and cognitive impairment.
- MRDSS2 shows potential as a valuable tool for monitoring disease progression and treatment efficacy in MS.
