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Published on: December 9, 2015
Association between age and inflammatory disease activity on magnetic resonance imaging in relapse onset multiple
Eline Coerver1, Sophie Janssens1, Aroosa Ahmed1
1MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam, The Netherlands, Amsterdam, the Netherlands.
Background And Purpose:
Inflammatory disease activity in multiple sclerosis (MS) decreases with advancing age. Previous work found a decrease in contrast-enhancing lesions (CELs) with age. Here, we describe the relation of age and magnetic resonance imaging (MRI) measures of inflammatory disease activity during long-term follow-up in a large real-world cohort of people with relapse onset MS.
Methods:
We investigated MRI data from the long-term observational Amsterdam MS cohort. We used logistic regression models and negative binomial generalized estimating equations to investigate the associations between age and radiological disease activity after a first clinical event.
Results:
We included 1063 participants and 10,651 cranial MRIs. Median follow-up time was 6.1 years (interquartile range = 2.4-10.9 years). Older participants had a significantly lower risk of CELs on baseline MRI (40-50 years vs. <40 years: odds ratio [OR] = 0.640, 95% confidence interval [CI] = 0.45-0.90; >50 years vs. <40 years: OR = 0.601, 95% CI = 0.33-1.08) and a lower risk of new T2 lesions or CELs during follow-up (40-50 years vs. <40 years: OR = 0.563, 95% CI = 0.47-0.67; >50 years vs. <40 years: OR = 0.486, 95% CI = 0.35-0.68).
Conclusions:
Greater age is associated with a lower risk of inflammatory MRI activity at baseline and during long-term follow-up. In patients aged >50 years, a less aggressive treatment strategy might be appropriate compared to younger patients.
Insights
Inflammatory disease activity in multiple sclerosis (MS) decreases with age. Older individuals show reduced MRI-detected inflammation, suggesting potential for adjusted treatment strategies.
Area of Science:
- Neurology
- Radiology
- Immunology
Background:
- Inflammatory disease activity in multiple sclerosis (MS) diminishes with age.
- Previous research indicated a decline in contrast-enhancing lesions (CELs) as individuals age.
Purpose of the Study:
- To investigate the relationship between age and magnetic resonance imaging (MRI) measures of inflammatory activity in a large, real-world cohort of MS patients.
- To analyze long-term follow-up data on radiological disease activity in relation to age.
Main Methods:
- Utilized MRI data from the Amsterdam MS cohort, a long-term observational study.
- Employed logistic regression and negative binomial generalized estimating equations to assess age-related associations with radiological disease activity.
- Included 1063 participants and 10,651 cranial MRIs with a median follow-up of 6.1 years.
Main Results:
- Older participants exhibited a significantly lower risk of CELs on baseline MRI.
- Individuals aged 40-50 and over 50 years showed reduced odds of baseline CELs compared to those under 40.
- A lower risk of new T2 lesions or CELs during follow-up was observed in older age groups.
Conclusions:
- Advanced age is linked to a decreased risk of inflammatory MRI activity in MS patients, both at baseline and over time.
- Patients over 50 years old may benefit from less aggressive treatment strategies compared to younger MS patients.
