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Disability Improvement Is Associated with Less Brain Atrophy Development in Multiple Sclerosis
E Ghione1, N Bergsland1,2, M G Dwyer1,3
1From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., D.P.R., R.Z.), Buffalo Neuroimaging Analysis Center.
AJNR. American Journal of Neuroradiology
|August 9, 2020
Summary
Patients with multiple sclerosis (MS) who show disability improvement experience less brain atrophy over time compared to those with worsening disability. This finding suggests a link between clinical improvement and reduced brain volume loss in MS patients.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Brain atrophy is a key feature in multiple sclerosis (MS).
- The relationship between clinical disability changes and the rate of brain atrophy in MS is not well understood.
- Investigating this association can inform disease management and treatment strategies.
Purpose of the Study:
- To determine if patients with MS experiencing disability improvement exhibit less brain atrophy compared to those with disability progression or stable disease.
- To quantify and compare brain volume changes and lateral ventricle expansion across different disability trajectories in MS patients.
Main Methods:
- Longitudinal study of 980 MS patients over approximately 4.8 years.
- Patients categorized into disability progress, disability improvement, or stable groups based on Expanded Disability Status Scale (EDSS) changes.
- Normalized whole-brain volume and lateral ventricle volume assessed using SIENAX and NeuroSTREAM, respectively, from MRI scans.
- Statistical analysis using ANCOVA to compare atrophy rates, adjusting for relevant covariates.
Main Results:
- No significant baseline differences in whole-brain or lateral ventricle volume among the groups.
- Patients with disability improvement showed significantly lower annualized lateral ventricle volume change (1.6%) compared to stable (2.1%) and progress (4.1%) groups (P < .001).
- Annualized brain volume change was also significantly lower in the disability improvement group (-0.7%) versus stable (-0.8%) and progress (-1.1%) groups (P = .001).
Conclusions:
- Disability improvement in MS patients is associated with a reduced rate of brain atrophy.
- Slower brain volume loss and lateral ventricle expansion correlate with clinical disability improvement in multiple sclerosis.
- These findings highlight the potential for neuroprotective effects or treatment efficacy in MS patients showing clinical gains.
