A three-year, multi-parametric MRI study in patients at presentation with CIS

Objectives To define the extent of overall brain damage in patients with clinically isolated syndromes (CIS) suggestive of multiple sclerosis (MS) and to identify non-conventional magnetic resonance (MR) metrics predictive of evolution to definite MS. Methods Brain conventional and magnetization tra...

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Veröffentlicht in:Journal of neurology Jg. 255; H. 5; S. 683 - 691
Hauptverfasser: Rocca, M. A., Agosta, F., Sormani, M. P., Fernando, K., Tintorè, M., Korteweg, T., Tortorella, P., Miller, D. H., Thompson, A., Rovira, A., Montalban, X., Polman, C., Barkhof, F., Filippi, M.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Darmstadt Steinkopff-Verlag 01.05.2008
Springer
Springer Nature B.V
Schlagworte:
Adult
Atrophy - diagnosis
Atrophy - physiopathology
Biological and medical sciences
Brain - pathology
Brain - physiopathology
Brain damage
Disability Evaluation
Disease Progression
Female
Humans
Image Processing, Computer-Assisted
Longitudinal Studies
Magnetic Resonance Imaging - methods
Male
Mass Screening
Medical sciences
Medicine
Medicine & Public Health
Multiple sclerosis
Multiple Sclerosis - diagnosis
Multiple Sclerosis - physiopathology
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Neurology
Neuroradiology
Neurosciences
Original Communication
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Factors
Severity of Illness Index
Spinal cord
Syndrome
United Kingdom > UK
Netherlands
Spain
predictors
magnetization transfer
disease evolution
MRI
clinically isolated syndrome
multiple sclerosis
Human
Nervous system diseases
Multiple sclerosis
Magnetization
Nuclear magnetic resonance imaging
Inflammatory disease
Central nervous system disease
Evolution
ISSN:0340-5354, 1432-1459
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Zusammenfassung:Objectives To define the extent of overall brain damage in patients with clinically isolated syndromes (CIS) suggestive of multiple sclerosis (MS) and to identify non-conventional magnetic resonance (MR) metrics predictive of evolution to definite MS. Methods Brain conventional and magnetization transfer (MT) MRI scans were obtained from 208 CIS patients and 55 matched healthy controls, recruited in four centres. Patients were assessed clinically at the time of MRI acquisition and after a median period of 3.1 years from disease onset. The following measures were derived: T2, T1 and gadolinium (Gd)- enhancing lesion volumes (LV), normalized brain volume (NBV), MTR histogram-derived quantities of the normal-appearing white matter (NAWM) and grey matter (GM). Results During the follow-up, 43 % of the patients converted to definite MS. At baseline, a significant inter-centre heterogeneity was detected for T2 LV (p = 0.003), T1 LV (p = 0.006), NBV (p < 0.001) and MTR histogram-derived metrics (p < 0.001). Pooled average MTR values differed between CIS patients and controls for NAWM (p = 0.003) and GM (p = 0.01). Gdactivity and positivity of International Panel (IP) criteria for disease dissemination in space (DIS), but not NAWM and GM MTR and NBV, were associated with evolution to definite MS. The final multivariable model retained only MRI IP criteria for DIS (p = 0.05; HR = 1.66, 95 % CI = 1.00–2.77) as an independent predictor of evolution to definite MS. Conclusions Although irreversible tissue injury is present from the earliest clinical stages of MS, macroscopic focal lesions but not "diffuse" brain damage measured by MTR are associated to an increased risk of subsequent development of definite MS in CIS patients.
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ISSN:0340-5354
1432-1459
DOI:10.1007/s00415-008-0776-z