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Composite MRI measures and short-term disability in patients with clinically isolated syndrome suggestive of MS
Giulia Bommarito1, Alessandro Bellini2, Matteo Pardini1
1Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy/IRCCS AOU San Martino-IST, Genoa, Italy.
Background:
The use of composite magnetic resonance imaging (MRI) measures has been suggested to better explain disability in patients with multiple sclerosis (MS). However, little is known about the utility of composite scores at the earliest stages of the disease.
Objective:
To investigate whether, in patients with clinically isolated syndrome (CIS), a composite MRI measure, rather than the single metrics, would explain conversion to MS and would better correlate with disability at baseline and at 1 year of follow-up.
Methods:
Corticospinal tract (CST), corpus callosum (CC) and optic radiation (OR) volume, fractional anisotropy (FA), and mean diffusivity (MD) values were measured in 27 CIS patients and 24 healthy controls (HCs). Z-scores of FA, MD, and tract volume measures were calculated in patients, based on the corresponding measures obtained from HCs, and then combined in a composite score for each tract. Correlations between Z-scores at baseline and both the Expanded Disability Status Scale (EDSS) at baseline and at follow-up (FU-EDSS) were investigated.
Results:
Only CST, CC, and OR composite scores as well as the CST volume were significantly associated with FU-EDSS ( p = 0.005, p = 0.007, p = 0.020, and p = 0.010, respectively).
Conclusion:
The combination of MRI measures rather than the individual metrics better captured the association between tissue damage in both the CC, OR and CST and short-term follow-up disability.
Insights
Composite magnetic resonance imaging (MRI) scores better explain disability in early multiple sclerosis (MS) than individual metrics. This study shows combined MRI measures in the corticospinal tract, corpus callosum, and optic radiation correlate with disability progression.
Area of Science:
- Neuroimaging
- Neurology
- Biomedical Engineering
Background:
- Composite magnetic resonance imaging (MRI) measures may better explain disability in multiple sclerosis (MS).
- The utility of composite MRI scores in the earliest stages of MS, such as clinically isolated syndrome (CIS), is not well understood.
Purpose of the Study:
- To determine if composite MRI measures, compared to single metrics, explain conversion to MS in CIS patients.
- To assess if composite MRI measures correlate better with disability at baseline and 1-year follow-up in CIS patients.
Main Methods:
- Measured corticospinal tract (CST), corpus callosum (CC), and optic radiation (OR) volume, fractional anisotropy (FA), and mean diffusivity (MD) in 27 CIS patients and 24 healthy controls (HCs).
- Calculated Z-scores for FA, MD, and tract volume based on HC data, creating composite scores for each tract.
- Correlated baseline composite Z-scores with baseline and 1-year follow-up Expanded Disability Status Scale (EDSS) scores.
Main Results:
- Composite scores for CST, CC, and OR, along with CST volume, were significantly associated with 1-year follow-up EDSS scores.
- Individual MRI metrics alone did not show the same level of association with disability progression as the composite scores.
Conclusions:
- Combined MRI measures, specifically composite scores for CST, CC, and OR, better capture the relationship between white matter damage and short-term disability in early MS.
- Composite MRI scoring offers a more comprehensive approach to assessing disability progression in patients with CIS.