Document Detail

Volumetric MRI markers and predictors of disease activity in early multiple sclerosis: a longitudinal cohort study.
MedLine Citation:
PMID:  23166826     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To compare clinical and MRI parameters between patients with clinically isolated syndrome and those converting to clinically definite multiple sclerosis within 2 years, to identify volumetric MRI predictors of this conversion and to assess effect of early relapses.
METHODS: The SET study comprised 220 patients with clinically isolated syndrome treated with interferon beta (mean age, 29 years; Expanded Disability Status Scale, 1.5). Three patients with missing data were excluded from the analysis. Physical disability, time to clinically definite multiple sclerosis and volumetric MRI data were recorded for 2 years.
RESULTS: Patients reaching clinically definite multiple sclerosis showed impaired recovery of neurological function, faster decrease in corpus callosum cross-sectional area, higher T2 lesion volume and more contrast-enhancing lesions. Six-month decrease in corpus callosum cross-sectional area (≥ 1%) and baseline T2 lesion volume (≥ 5 cm(3)) predicted clinically definite multiple sclerosis within 2 years (hazard ratios 2.5 and 1.8, respectively). Of 22 patients fulfilling both predictive criteria, 83% reached clinically definite multiple sclerosis (hazard ratio 6.5). More relapses were associated with poorer recovery of neurological function and accelerated brain atrophy.
CONCLUSIONS: Neurological impairment is more permanent, brain atrophy is accelerated and focal inflammatory activity is greater in patients converting to clinically definite multiple sclerosis. Six-month corpus callosum atrophy and baseline T2 lesion volume jointly help predict individual risk of clinically definite multiple sclerosis. Early relapses contribute to permanent damage of the central nervous system.
Tomas Kalincik; Manuela Vaneckova; Michaela Tyblova; Jan Krasensky; Zdenek Seidl; Eva Havrdova; Dana Horakova
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-11-15
Journal Detail:
Title:  PloS one     Volume:  7     ISSN:  1932-6203     ISO Abbreviation:  PLoS ONE     Publication Date:  2012  
Date Detail:
Created Date:  2012-11-20     Completed Date:  2013-04-29     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  101285081     Medline TA:  PLoS One     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e50101     Citation Subset:  IM    
Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic.
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MeSH Terms
Cohort Studies
Corpus Callosum / pathology
Czech Republic
Demyelinating Diseases / diagnosis*,  drug therapy
Disease Progression
Interferon-beta / therapeutic use
Longitudinal Studies
Magnetic Resonance Imaging / methods*
Middle Aged
Multiple Sclerosis / diagnosis*,  pathology*
Predictive Value of Tests
Proportional Hazards Models
Reg. No./Substance:

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