Contributions
Abstract: P1594
Type: LB Poster
Abstract Category: Late Breaking News
Background: There are no accepted cut-off values of pathological global and regional brain atrophy rate representing volumetric MRI surrogate markers of disease progression.
Objective: To establish cut-off values able to discriminate between physiological and pathological brain volume loss in patients with multiple sclerosis (MS).
Methods: 107 MS patients after first demyelinating event suggestive of MS from the SET study, 139 relapsing-remitting MS patients from the ASA study, 1189 heterogenous MS patients from the volumetric MRI programme and 78 healthy controls (HC) were included in this longitudinal study. A total of 11838 MRI scans, performed on the same MRI scanner with the same MRI protocol, were analysed. Mean number of MRI scans per patients was 3.6 in HC and 8.0 in MS patients. Mean follow-up duration was 7.4 years in HC and 6.6 years in MS patients. Annualized percentage changes (APC) of global (whole brain) and regional (corpus callosum, gray matter and lateral ventricle) volumes were estimated. We identified the cut-off values of APC´s of brain volume loss rates to discriminate between HC and MS patients with a high specificity.
Results: At the predefined level of specificity 90%, APC cut-off value of corpus callosum (< -0.67%) was discriminator between HC and MS patients with highest sensitivity (39% in patients after first demyelinating event suggestive of MS, 44% in relapsing-remitting patients and 43% in heterogeneous MS patients group). Lower sensitivity was found for APC´s cut-off values of whole brain (cut-off < -0.45%; 17-34% sensitivity), gray matter (cut-off < -0.79%; 21-32% sensitivity) and lateral ventricle (cut-off >4.69%; 22-40% sensitivity). In the relapsing-remitting MS patients, cut-off values of APC´s of brain volume loss were associated with greater accumulation of disability assessed by annualized absolute expanded disability status scale (EDSS) (p=< 0.001-0.014). Annualized change of EDSS was not significant in SET cohort and was not investigated in heterogeneous MS cohort.
Conclusions: We identified cut-off values of annualized global and regional brain volume loss rates able to discriminate between physiological and pathological brain volume loss rates in a different subgroups of MS patients with a high specificity but relatively low sensitivity. Established cut-off values were associated with greater accumulation of disability in relapsing-remitting MS cohort supporting its clinical relevance.
Disclosure:
Dr. Uher received financial support for conference travel and honoraria from Biogen Idec, Novartis, Genzyme and Merck Serono, as well as support for research activities from Biogen Idec. This research was conducted white Dr. Tomas Uher was an MSBase Fellow.
Dr. Vaneckova received received compensation for speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono and Teva, as well as support for research activities from Biogen Idec.
Sobisek received funding for biostatistical support from Novartis.
Drs. Seidl and Krasensky received financial support for research activities from Biogen Idec.
Drs. Tyblova and Volna received compensation for travel and honoraria from Biogen Idec, Sanofi Aventis, Teva, and Merck Serono.
Dr. Havrdova received speaker honoraria and consultant fees from Biogen Idec, Merck Serono, Novartis, Genzyme, Actelion, Receptos and Teva, as well as support for research activities from Biogen Idec and Merck Serono.
Dr. Horakova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono, Bayer Shering, and Teva, as well as support for research activities from Biogen Idec.
Abstract: P1594
Type: LB Poster
Abstract Category: Late Breaking News
Background: There are no accepted cut-off values of pathological global and regional brain atrophy rate representing volumetric MRI surrogate markers of disease progression.
Objective: To establish cut-off values able to discriminate between physiological and pathological brain volume loss in patients with multiple sclerosis (MS).
Methods: 107 MS patients after first demyelinating event suggestive of MS from the SET study, 139 relapsing-remitting MS patients from the ASA study, 1189 heterogenous MS patients from the volumetric MRI programme and 78 healthy controls (HC) were included in this longitudinal study. A total of 11838 MRI scans, performed on the same MRI scanner with the same MRI protocol, were analysed. Mean number of MRI scans per patients was 3.6 in HC and 8.0 in MS patients. Mean follow-up duration was 7.4 years in HC and 6.6 years in MS patients. Annualized percentage changes (APC) of global (whole brain) and regional (corpus callosum, gray matter and lateral ventricle) volumes were estimated. We identified the cut-off values of APC´s of brain volume loss rates to discriminate between HC and MS patients with a high specificity.
Results: At the predefined level of specificity 90%, APC cut-off value of corpus callosum (< -0.67%) was discriminator between HC and MS patients with highest sensitivity (39% in patients after first demyelinating event suggestive of MS, 44% in relapsing-remitting patients and 43% in heterogeneous MS patients group). Lower sensitivity was found for APC´s cut-off values of whole brain (cut-off < -0.45%; 17-34% sensitivity), gray matter (cut-off < -0.79%; 21-32% sensitivity) and lateral ventricle (cut-off >4.69%; 22-40% sensitivity). In the relapsing-remitting MS patients, cut-off values of APC´s of brain volume loss were associated with greater accumulation of disability assessed by annualized absolute expanded disability status scale (EDSS) (p=< 0.001-0.014). Annualized change of EDSS was not significant in SET cohort and was not investigated in heterogeneous MS cohort.
Conclusions: We identified cut-off values of annualized global and regional brain volume loss rates able to discriminate between physiological and pathological brain volume loss rates in a different subgroups of MS patients with a high specificity but relatively low sensitivity. Established cut-off values were associated with greater accumulation of disability in relapsing-remitting MS cohort supporting its clinical relevance.
Disclosure:
Dr. Uher received financial support for conference travel and honoraria from Biogen Idec, Novartis, Genzyme and Merck Serono, as well as support for research activities from Biogen Idec. This research was conducted white Dr. Tomas Uher was an MSBase Fellow.
Dr. Vaneckova received received compensation for speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono and Teva, as well as support for research activities from Biogen Idec.
Sobisek received funding for biostatistical support from Novartis.
Drs. Seidl and Krasensky received financial support for research activities from Biogen Idec.
Drs. Tyblova and Volna received compensation for travel and honoraria from Biogen Idec, Sanofi Aventis, Teva, and Merck Serono.
Dr. Havrdova received speaker honoraria and consultant fees from Biogen Idec, Merck Serono, Novartis, Genzyme, Actelion, Receptos and Teva, as well as support for research activities from Biogen Idec and Merck Serono.
Dr. Horakova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono, Bayer Shering, and Teva, as well as support for research activities from Biogen Idec.