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Multiple Sclerosis l: Introduction01:19

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Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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Multiple Sclerosis-Specific Reference Curves for Brain Volumes to Explain Disease Severity.

David Rudolf van Nederpelt1, Lonneke Bos1, Rozemarijn M Mattiesing1

  • 1MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmc, the Netherlands.

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Summary
This summary is machine-generated.

A new multiple sclerosis (MS)-specific brain volume model improves disease severity assessment compared to healthy control (HC) reference curves. This MS model better correlates with disease severity scores, aiding clinical implementation for people with MS.

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Area of Science:

  • Neurology
  • Radiology
  • Biostatistics

Background:

  • Brain atrophy is a key indicator of disease progression and treatment response in people with multiple sclerosis (pwMS).
  • Current automated tools often use healthy control (HC) reference curves, which may not accurately reflect brain volume changes specific to MS.
  • Developing an MS-specific reference model is crucial for precise interpretation of brain volumes in pwMS.

Purpose of the Study:

  • To develop and validate a novel MS-specific reference model for brain volumes.
  • To evaluate the performance of the MS-specific model against traditional HC-based reference curves.
  • To assess the model's potential for improving clinical assessment of disease severity in pwMS.

Main Methods:

  • Normalized brain volumes (NBVs) were analyzed from T1-weighted MRI scans of pwMS and HCs from the Amsterdam MS cohort.
  • An MS-specific regression model was created using NBVs, age, sex, disease duration, and MS phenotype.
  • The MS model classified pwMS into NBV deviation quartiles, which were compared with HC-based quartiles using disease severity metrics (MSSS, SDMT, 9HPT).

Main Results:

  • The MS-specific model, incorporating age, sex, disease duration, and phenotype, showed significantly stronger associations with the MS severity score (MSSS) than HC-based quartiles (p = 2.2*10^-9).
  • Lower NBV quartiles in the MS model correlated with worsening MSSS values, a finding not observed with HC-based quartiles.
  • The MS-specific model also demonstrated improved associations with 9-Hole Peg Test (9HPT) and Symbol Digit Modalities Test (SDMT) scores.

Conclusions:

  • An MS-specific reference model for brain volumes provides more relevant assessments of disease severity in pwMS compared to HC-based models.
  • The developed MS model enhances the correlation with established clinical disability measures.
  • Further refinement of the MS model for individual patient application could significantly improve clinical implementation and patient care.