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Technology-enabled comprehensive characterization of multiple sclerosis in clinical practice.

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Comprehensive neurological assessments in multiple sclerosis (MS) show neuroperformance tests (NPTs) correlate with patient-reported outcomes and MRI measures. This supports objective MS monitoring in clinical and research settings.

Keywords:
Multiple sclerosisOutcome measurementPatient-reported outcome measuresQuality of lifeQuantitative MRI

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Area of Science:

  • Neurology
  • Neuroscience
  • Medical Imaging

Background:

  • Objective and longitudinal disability measurements are crucial for monitoring multiple sclerosis (MS) disease status and treatment response.
  • Technology-enabled comprehensive assessments, including neuroperformance tests (NPTs), patient-reported outcome measures (PROMs), and MRI, are increasingly integrated into MS clinical care.
  • Real-world data on the relationships between NPTs, PROMs, and MRI measures in large MS cohorts remain incompletely understood.

Purpose of the Study:

  • To demonstrate the utility of comprehensive neurological assessment in MS.
  • To determine the associations between NPTs, PROMs, and quantitative MRI measures within a large MS clinical cohort.

Main Methods:

  • Collected data on NPTs (processing speed, contrast sensitivity, manual dexterity, walking speed) and physical disability PROMs (Neuro-QoL, PDDS, PROMIS-10 physical) during routine clinical care.
  • Utilized fully-automated MRI analysis to quantify T2-lesion volume (T2LV), whole brain fraction (WBF), thalamic volume (TV), and cervical spinal cord cross-sectional area (CA).
  • Employed Spearman's rank correlation and linear regression to evaluate cross-sectional associations between NPTs, PROMs, and MRI measures.

Main Results:

  • Included 997 MS patients assessed over 2 years; moderate correlations were observed between NPTs and PROMs.
  • NPTs showed moderate correlations with MRI metrics, with processing speed (PST) exhibiting the strongest links to T2LV and WBF.
  • Linear regression identified various clinical, demographic, MRI, and PROM variables as significant predictors for each NPT, explaining substantial variance (adjusted R² from 0.30 to 0.46).

Conclusions:

  • Impaired NPT performance correlates with increased physical disability (PROMs) and greater MRI-assessed disease severity in MS patients.
  • This study validates the use of comprehensive, objective MS status quantification in clinical and research settings.
  • Future longitudinal studies are warranted to identify predictors of treatment response and disability progression.