Document Detail


MRI as a marker for disease heterogeneity in multiple sclerosis.
MedLine Citation:
PMID:  16217061     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Whereas recent data from imaging studies challenge the prevailing notion that multiple sclerosis (MS) is purely an inflammatory disease, pathologic studies suggest differences in the disease processes between individual patients with MS. The ability to dissect the pathophysiologic disease heterogeneity, if it indeed exists, by methodologies that can be applied in vivo is important both for the development of new therapeutics and for the ability to identify the optimal therapy for an individual patient. OBJECTIVE: To design a stratification algorithm for patients with MS based on accepted MRI measurements reflective of inflammation and axonal damage/tissue loss and to assess if such MS subgroups retain their intergroup differences long term. METHODS: Mathematical modeling was used to select three discriminatory MRI measures for clinical outcome based on the cross-sectional analysis of 71 patients with untreated MS and tested general applicability of the stratification scheme on the independent longitudinal cohort of 71 MS patients. RESULTS: By consecutive employment of MRI measures reflective of inflammation and tissue loss, the authors were able to separate MS patients into four clinically meaningful subgroups. The analysis of the longitudinal confirmatory cohort demonstrated persistence of the intergroup differences in selected MRI measures for 8 years. CONCLUSIONS: The inflammatory activity and destructiveness of the multiple sclerosis process are to some degree independent of each other, and the successive evaluation of both of these variables can strengthen prediction of clinical outcome in individual patients.
Authors:
B Bielekova; N Kadom; E Fisher; N Jeffries; J Ohayon; N Richert; T Howard; C N Bash; J A Frank; L Stone; R Martin; G Cutter; H F McFarland
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural; Research Support, U.S. Gov't, P.H.S.; Validation Studies    
Journal Detail:
Title:  Neurology     Volume:  65     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-11     Completed Date:  2006-03-09     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1071-6     Citation Subset:  AIM; IM    
Affiliation:
Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD 20892-1400, USA. bielekob@ninds.nih.gov
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MeSH Terms
Descriptor/Qualifier:
Adult
Algorithms*
Axons / pathology
Biological Markers
Central Nervous System / pathology,  physiopathology
Cohort Studies
Cross-Sectional Studies
Diagnosis, Differential
Disease Progression
Female
Humans
Inflammation / diagnosis,  physiopathology
Longitudinal Studies
Magnetic Resonance Imaging / methods*,  standards
Male
Middle Aged
Models, Theoretical
Multiple Sclerosis / classification*,  diagnosis*,  physiopathology
Predictive Value of Tests
Prognosis
Wallerian Degeneration / diagnosis*,  physiopathology
Grant Support
ID/Acronym/Agency:
RG3223A2/1/RG/CSR NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers

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