A systematic literature review of the association between global brain atrophy and the Expanded Disability Status Scale score in people with multiple sclerosis

Brain atrophy (BA) is a useful predictor of clinical outcomes in people with multiple sclerosis (PwMS). For this reason, MAGNIMS (Magnetic Resonance Imaging in Multiple Sclerosis), an expert consensus group, recommended that global brain volume loss (BVL) is included as a secondary outcome in therap...

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Published in:Therapeutic advances in neurological disorders Vol. 18; p. 17562864241303681
Main Authors: Zivadinov, Robert, Le, Hoa H., Keenan, Alexander, Stocks, Susan Jill
Format: Journal Article
Language:English
Published: England SAGE Publications 01.01.2025
SAGE Publishing
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Systematic Review
brain atrophy
brain volume loss
disability
multiple sclerosis
ISSN:1756-2864, 1756-2856, 1756-2864
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Abstract Brain atrophy (BA) is a useful predictor of clinical outcomes in people with multiple sclerosis (PwMS). For this reason, MAGNIMS (Magnetic Resonance Imaging in Multiple Sclerosis), an expert consensus group, recommended that global brain volume loss (BVL) is included as a secondary outcome in therapeutic clinical trials. However, there has not been a recent review of the evidence of the association, or strength of association, between global BA and disability in PwMS. Our aim is to review articles from 2013 onward measuring the associations between percentage of brain volume loss (PBVL), normalized brain volumes (NBV) or normalized brain parenchymal volume (NBPV), and the Expanded Disability Status Scale (EDSS), or disability progression (DP) measured by EDSS in PwMS. Systematic review. We searched Medline, Embase, Cochrane Library, Cochrane Clinical Register of Controlled Trials, Cochrane Database of Systematic Reviews and Cumulative Index to Nursing and Allied Health Literature for observational studies, clinical trials and modelling studies measuring the association between global BVL, PBVL, NBV or NBPV, and EDSS score or DP in PwMS. We included people with clinically isolated syndrome and excluded studies with a population greater than 20% primary progressive multiple sclerosis patients. We found 58 studies were eligible for the review. Most longitudinal studies (19/23) observed a significant association between global BVL and change in EDSS score or DP. Similarly the majority of cross-sectional studies (26/29) observed an association between baseline BV measures and EDSS. Most studies investigating the association between baseline brain volume (BV) measures and follow-up EDSS, that is, asking if baseline BV is a predictor of DP, or future EDSS score, did not find an association (4/15 observed an association). Around a 1% (range 0.4%-1.3%) decrease in global BV per year was associated with DP, but caution in comparing studies is recommended due to variations in the definition of DP.
AbstractList Brain atrophy (BA) is a useful predictor of clinical outcomes in people with multiple sclerosis (PwMS). For this reason, MAGNIMS (Magnetic Resonance Imaging in Multiple Sclerosis), an expert consensus group, recommended that global brain volume loss (BVL) is included as a secondary outcome in therapeutic clinical trials. However, there has not been a recent review of the evidence of the association, or strength of association, between global BA and disability in PwMS.BackgroundBrain atrophy (BA) is a useful predictor of clinical outcomes in people with multiple sclerosis (PwMS). For this reason, MAGNIMS (Magnetic Resonance Imaging in Multiple Sclerosis), an expert consensus group, recommended that global brain volume loss (BVL) is included as a secondary outcome in therapeutic clinical trials. However, there has not been a recent review of the evidence of the association, or strength of association, between global BA and disability in PwMS.Our aim is to review articles from 2013 onward measuring the associations between percentage of brain volume loss (PBVL), normalized brain volumes (NBV) or normalized brain parenchymal volume (NBPV), and the Expanded Disability Status Scale (EDSS), or disability progression (DP) measured by EDSS in PwMS.ObjectivesOur aim is to review articles from 2013 onward measuring the associations between percentage of brain volume loss (PBVL), normalized brain volumes (NBV) or normalized brain parenchymal volume (NBPV), and the Expanded Disability Status Scale (EDSS), or disability progression (DP) measured by EDSS in PwMS.Systematic review.DesignSystematic review.We searched Medline, Embase, Cochrane Library, Cochrane Clinical Register of Controlled Trials, Cochrane Database of Systematic Reviews and Cumulative Index to Nursing and Allied Health Literature for observational studies, clinical trials and modelling studies measuring the association between global BVL, PBVL, NBV or NBPV, and EDSS score or DP in PwMS. We included people with clinically isolated syndrome and excluded studies with a population greater than 20% primary progressive multiple sclerosis patients.MethodsWe searched Medline, Embase, Cochrane Library, Cochrane Clinical Register of Controlled Trials, Cochrane Database of Systematic Reviews and Cumulative Index to Nursing and Allied Health Literature for observational studies, clinical trials and modelling studies measuring the association between global BVL, PBVL, NBV or NBPV, and EDSS score or DP in PwMS. We included people with clinically isolated syndrome and excluded studies with a population greater than 20% primary progressive multiple sclerosis patients.We found 58 studies were eligible for the review. Most longitudinal studies (19/23) observed a significant association between global BVL and change in EDSS score or DP. Similarly the majority of cross-sectional studies (26/29) observed an association between baseline BV measures and EDSS. Most studies investigating the association between baseline brain volume (BV) measures and follow-up EDSS, that is, asking if baseline BV is a predictor of DP, or future EDSS score, did not find an association (4/15 observed an association).ResultsWe found 58 studies were eligible for the review. Most longitudinal studies (19/23) observed a significant association between global BVL and change in EDSS score or DP. Similarly the majority of cross-sectional studies (26/29) observed an association between baseline BV measures and EDSS. Most studies investigating the association between baseline brain volume (BV) measures and follow-up EDSS, that is, asking if baseline BV is a predictor of DP, or future EDSS score, did not find an association (4/15 observed an association).Around a 1% (range 0.4%-1.3%) decrease in global BV per year was associated with DP, but caution in comparing studies is recommended due to variations in the definition of DP.ConclusionAround a 1% (range 0.4%-1.3%) decrease in global BV per year was associated with DP, but caution in comparing studies is recommended due to variations in the definition of DP.
Background: Brain atrophy (BA) is a useful predictor of clinical outcomes in people with multiple sclerosis (PwMS). For this reason, MAGNIMS (Magnetic Resonance Imaging in Multiple Sclerosis), an expert consensus group, recommended that global brain volume loss (BVL) is included as a secondary outcome in therapeutic clinical trials. However, there has not been a recent review of the evidence of the association, or strength of association, between global BA and disability in PwMS. Objectives: Our aim is to review articles from 2013 onward measuring the associations between percentage of brain volume loss (PBVL), normalized brain volumes (NBV) or normalized brain parenchymal volume (NBPV), and the Expanded Disability Status Scale (EDSS), or disability progression (DP) measured by EDSS in PwMS. Design: Systematic review. Methods: We searched Medline, Embase, Cochrane Library, Cochrane Clinical Register of Controlled Trials, Cochrane Database of Systematic Reviews and Cumulative Index to Nursing and Allied Health Literature for observational studies, clinical trials and modelling studies measuring the association between global BVL, PBVL, NBV or NBPV, and EDSS score or DP in PwMS. We included people with clinically isolated syndrome and excluded studies with a population greater than 20% primary progressive multiple sclerosis patients. Results: We found 58 studies were eligible for the review. Most longitudinal studies (19/23) observed a significant association between global BVL and change in EDSS score or DP. Similarly the majority of cross-sectional studies (26/29) observed an association between baseline BV measures and EDSS. Most studies investigating the association between baseline brain volume (BV) measures and follow-up EDSS, that is, asking if baseline BV is a predictor of DP, or future EDSS score, did not find an association (4/15 observed an association). Conclusion: Around a 1% (range 0.4%–1.3%) decrease in global BV per year was associated with DP, but caution in comparing studies is recommended due to variations in the definition of DP.
Brain atrophy (BA) is a useful predictor of clinical outcomes in people with multiple sclerosis (PwMS). For this reason, MAGNIMS (Magnetic Resonance Imaging in Multiple Sclerosis), an expert consensus group, recommended that global brain volume loss (BVL) is included as a secondary outcome in therapeutic clinical trials. However, there has not been a recent review of the evidence of the association, or strength of association, between global BA and disability in PwMS. Our aim is to review articles from 2013 onward measuring the associations between percentage of brain volume loss (PBVL), normalized brain volumes (NBV) or normalized brain parenchymal volume (NBPV), and the Expanded Disability Status Scale (EDSS), or disability progression (DP) measured by EDSS in PwMS. Systematic review. We searched Medline, Embase, Cochrane Library, Cochrane Clinical Register of Controlled Trials, Cochrane Database of Systematic Reviews and Cumulative Index to Nursing and Allied Health Literature for observational studies, clinical trials and modelling studies measuring the association between global BVL, PBVL, NBV or NBPV, and EDSS score or DP in PwMS. We included people with clinically isolated syndrome and excluded studies with a population greater than 20% primary progressive multiple sclerosis patients. We found 58 studies were eligible for the review. Most longitudinal studies (19/23) observed a significant association between global BVL and change in EDSS score or DP. Similarly the majority of cross-sectional studies (26/29) observed an association between baseline BV measures and EDSS. Most studies investigating the association between baseline brain volume (BV) measures and follow-up EDSS, that is, asking if baseline BV is a predictor of DP, or future EDSS score, did not find an association (4/15 observed an association). Around a 1% (range 0.4%-1.3%) decrease in global BV per year was associated with DP, but caution in comparing studies is recommended due to variations in the definition of DP.
Author Zivadinov, Robert
Stocks, Susan Jill
Keenan, Alexander
Le, Hoa H.
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  surname: Zivadinov
  fullname: Zivadinov, Robert
  organization: Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA, Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA
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  givenname: Hoa H.
  surname: Le
  fullname: Le, Hoa H.
  organization: Real World Value & Evidence, Janssen Scientific Affairs, LLC, Titusville, NJ, USA
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  givenname: Alexander
  orcidid: 0009-0006-4805-7606
  surname: Keenan
  fullname: Keenan, Alexander
  organization: Real World Value & Evidence, Janssen Scientific Affairs, LLC, 1125 Trenton-Harbourton Road, Titusville, NJ 08560, USA
– sequence: 4
  givenname: Susan Jill
  orcidid: 0000-0001-6034-476X
  surname: Stocks
  fullname: Stocks, Susan Jill
  organization: Open Health, The Weighbridge, Brewery Courtyard, Marlow, Buckinghamshire, UK
BackLink https://www.ncbi.nlm.nih.gov/pubmed/40689156$$D View this record in MEDLINE/PubMed
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Keywords brain atrophy
brain volume loss
disability
multiple sclerosis
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Snippet Brain atrophy (BA) is a useful predictor of clinical outcomes in people with multiple sclerosis (PwMS). For this reason, MAGNIMS (Magnetic Resonance Imaging in...
Background: Brain atrophy (BA) is a useful predictor of clinical outcomes in people with multiple sclerosis (PwMS). For this reason, MAGNIMS (Magnetic...
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Title A systematic literature review of the association between global brain atrophy and the Expanded Disability Status Scale score in people with multiple sclerosis
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