| MRI as a marker for disease heterogeneity in multiple sclerosis. | |
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MedLine Citation:
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PMID: 16217061 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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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:
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Title: Neurology Volume: 65 ISSN: 1526-632X ISO Abbreviation: Neurology Publication Date: 2005 Oct |
Date Detail:
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Created Date: 2005-10-11 Completed Date: 2006-03-09 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0401060 Medline TA: Neurology Country: United States |
Other Details:
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Languages: eng Pagination: 1071-6 Citation Subset: AIM; IM |
Affiliation:
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Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD 20892-1400, USA. bielekob@ninds.nih.gov |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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RG3223A2/1/RG/CSR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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