Relationship between brain atrophy and disability in a multi-site multiple sclerosis registry

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• Multiple Sclerosis (MS) is a chronic neurological disease.
• Brain atrophy is a key feature in MS progression.
• Standardized MRI metrics for predicting MS disability are needed.

Purpose of the Study:

• To investigate the association between brain atrophy metrics and disability in multiple sclerosis (MS).
• To evaluate the utility of different MRI scanners and protocols in assessing MS progression.
• To determine if MRI measures can predict future disability worsening in a real-world clinical setting.

Main Methods:

• Retrospective multicentre cohort study of relapse-onset MS patients.
• Inclusion criteria: two MRIs 12 months apart and ≥2 Expanded Disability Status Scale (EDSS) scores.
• MRI metrics assessed: Percentage Brain Volume Change (PBVC), Percentage Grey Matter Change (PGMC), and lesion volumes. Disability measured by EDSS and 6-month confirmed disability progression (CDP).

Main Results:

• Whole brain volume (BV) at later MRI associated with EDSS scores (p<0.001) and rate of EDSS change (p=0.02).
• No significant association found between longitudinal PBVC or PGMC and CDP or EDSS (p>0.05).
• Cross-sectional BV and grey matter volume (GMV) showed a trend for association with CDP (p=0.06).

Conclusions:

• In a highly treated MS cohort, only cross-sectional BV was associated with future EDSS scores.
• Current MRI metrics showed limitations in predicting 6-month confirmed disability progression.
• Findings underscore the challenges in using MRI to predict MS disability worsening in clinical practice.