Contributions
Abstract: P1642
Type: LB Poster
Abstract Category: Late Breaking News
Background: There is a well described correlation between lesion burden and brain atrophy in multiple sclerosis (MS) patients. However, it is unclear whether dissociation between lesion burden accumulation and brain volume loss is present in some MS patients.
Objective: To investigate characteristics and prevalence of dissociation between lesion volume accumulation and brain volume loss in a large cohort of MS patients over the long-term follow-up.
Methods: We included 1551 MS patients with at least 5 MRI scans (mean=9.2 scans per patient) and at least 4 years (mean=6.8 years) follow-up. Annualised percentage change of brain volume loss and annualised absolute change of T2 lesion volume (T2-LV) were estimated for each patient. Dissociation was defined as a simultaneous presence of the highest tercile of T2-LV accumulation and the lowest tercile of brain volume loss, or vice versa in an individual patient.
Results: Only 102 (6.8%) patients had dissociation between T2-LV and brain atrophy assessed by brain parenchymal fraction (BPF) at baseline. Only 182 (11.8%) patients had dissociation between lesion burden accumulation and brain volume loss over follow-up. More specifically, 91 (5.9%) patients had simultaneously high T2-LV accumulation (highest tercile) and relatively low brain volume loss (lowest tercile). Also, 91 (5.9%) patients had simultaneously present high brain volume loss (highest tercile) and relative low T2-LV accumulation (lowest tercile). Patients with disproportionally high T2-LV accumulation (median: +0.38 ml per year) and low brain volume loss (mean: -0.05% per year) had, compared with patients with high brain volume loss (mean: -0.48% per year) and low T2-LV accumulation (median: -0.07 ml per year): longer disease duration; higher age; lower T1/T2-LV ratio, greater T1 and T2-LV, greater expanded disability status scale and lower BPF at baseline (p=< 0.001-0.005) and lower whole brain, gray matter and lateral ventricle volume change over follow-up (p< 0.001).
Conclusions: Dissociation between T2-LV accumulation and brain volume loss occurs only in a small proportion of patients over follow-up. These findings support a close association between neuro-inflammatory and neuro-degenerative processes in MS. Further research is needed to investigate if different pathophysiological mechanisms, disease-modifying treatments or dominating gray matter or spinal pathology may explain occurrence of different MRI patterns.
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.
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.
Kucerova has nothing to disclose.
Abstract: P1642
Type: LB Poster
Abstract Category: Late Breaking News
Background: There is a well described correlation between lesion burden and brain atrophy in multiple sclerosis (MS) patients. However, it is unclear whether dissociation between lesion burden accumulation and brain volume loss is present in some MS patients.
Objective: To investigate characteristics and prevalence of dissociation between lesion volume accumulation and brain volume loss in a large cohort of MS patients over the long-term follow-up.
Methods: We included 1551 MS patients with at least 5 MRI scans (mean=9.2 scans per patient) and at least 4 years (mean=6.8 years) follow-up. Annualised percentage change of brain volume loss and annualised absolute change of T2 lesion volume (T2-LV) were estimated for each patient. Dissociation was defined as a simultaneous presence of the highest tercile of T2-LV accumulation and the lowest tercile of brain volume loss, or vice versa in an individual patient.
Results: Only 102 (6.8%) patients had dissociation between T2-LV and brain atrophy assessed by brain parenchymal fraction (BPF) at baseline. Only 182 (11.8%) patients had dissociation between lesion burden accumulation and brain volume loss over follow-up. More specifically, 91 (5.9%) patients had simultaneously high T2-LV accumulation (highest tercile) and relatively low brain volume loss (lowest tercile). Also, 91 (5.9%) patients had simultaneously present high brain volume loss (highest tercile) and relative low T2-LV accumulation (lowest tercile). Patients with disproportionally high T2-LV accumulation (median: +0.38 ml per year) and low brain volume loss (mean: -0.05% per year) had, compared with patients with high brain volume loss (mean: -0.48% per year) and low T2-LV accumulation (median: -0.07 ml per year): longer disease duration; higher age; lower T1/T2-LV ratio, greater T1 and T2-LV, greater expanded disability status scale and lower BPF at baseline (p=< 0.001-0.005) and lower whole brain, gray matter and lateral ventricle volume change over follow-up (p< 0.001).
Conclusions: Dissociation between T2-LV accumulation and brain volume loss occurs only in a small proportion of patients over follow-up. These findings support a close association between neuro-inflammatory and neuro-degenerative processes in MS. Further research is needed to investigate if different pathophysiological mechanisms, disease-modifying treatments or dominating gray matter or spinal pathology may explain occurrence of different MRI patterns.
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.
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.
Kucerova has nothing to disclose.