Document Detail


Grey matter damage predicts the evolution of primary progressive multiple sclerosis at 5 years.
MedLine Citation:
PMID:  16921179     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Reliable prognostic markers of primary progressive (PP) multiple sclerosis evolution are still needed. Diffusion tensor (DT) MRI can quantify normal-appearing white matter (NAWM) and grey matter (GM) damage in multiple sclerosis patients. We investigated whether conventional and DT-MRI-derived measures can predict the long-term clinical evolution of PP multiple sclerosis. In 54 PP multiple sclerosis patients, conventional and DT-MRI scans of the brain and T1-weighted scans of the cervical cord were acquired at baseline and after a median follow-up of 15 months. Another clinical evaluation was performed, 56 months after baseline, in 52 patients. Measures of lesion load, brain and cord atrophy were obtained. Histograms of the mean diffusivity (MD) and fractional anisotropy (FA) values from the NAWM and GM were analysed. At follow-up, 35 patients (65%) experienced a confirmed disability progression. Baseline expanded disability status scale score and average GM MD were independent predictors of subsequent clinical deterioration in a multivariable model (Nagelkerke R2: 0.44; discriminating ability: 81%). A lower level of disability and a more severe GM damage identify PP multiple sclerosis patients with an increased risk of disease progression over the subsequent 5 years. These data may be relevant to select patients for future exploratory phase II trials.
Authors:
M Rovaris; E Judica; A Gallo; B Benedetti; M P Sormani; D Caputo; A Ghezzi; E Montanari; A Bertolotto; G Mancardi; R Bergamaschi; V Martinelli; G Comi; M Filippi
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Publication Detail:
Type:  Journal Article     Date:  2006-08-18
Journal Detail:
Title:  Brain : a journal of neurology     Volume:  129     ISSN:  1460-2156     ISO Abbreviation:  Brain     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-26     Completed Date:  2006-11-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372537     Medline TA:  Brain     Country:  England    
Other Details:
Languages:  eng     Pagination:  2628-34     Citation Subset:  AIM; IM    
Affiliation:
Neuroimaging Research Unit, Department of Neurology, San Raffaele Scientific Institute, Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Brain / pathology*
Cervical Vertebrae
Disease Progression
Follow-Up Studies
Humans
Image Interpretation, Computer-Assisted*
Image Processing, Computer-Assisted
Magnetic Resonance Imaging*
Middle Aged
Multiple Sclerosis, Chronic Progressive / pathology*
Multivariate Analysis
Prognosis
ROC Curve
Sensitivity and Specificity
Spinal Cord / pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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