Contributions
Abstract: P325
Type: Poster
Abstract Category: Clinical aspects of MS - MS and gender
Background: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS). During the last decades, the prevalence ratio of women to men has notably increased (2-3:1). This may be attributed to hormonal, genetic and lifestyle differences between genders. Female life span is marked by several hormonal changes starting from menarche, through child bearing years, ending with menopause. The effect of hormonal changes on MRI outcome measures in MS patients is still poorly understood.
Objective: To investigate the effect of different age of menarche on MS inflammatory and neurodegenerative MRI outcome measures.
Methods: This study utilized data from an ongoing prospective Cardiovascular, Environmental, Genetic (CEG) study. 276 female MS patients who underwent full clinical examination, MRI assessment on 3T MRI scanner and completed an epidemiological questionnaire regarding reproductive history were selected. Grey matter (GM) volume, white matter (WM) volume, cortical volume and ventricular cerebrospinal fluid (vCSF) volume were calculated using SIENAX cross-sectional software. Volumes of total deep grey matter, thalamus, caudate nucleus, putamen, globus pallidus and hippocampus were measured using fMRIB"s Integrated Registration and Segmentation Tool (FIRST) software. T2-, T1- and gadolinium- (Gd) lesion volumes (LV) and lesion numbers (LN) were calculated using a reliable semi-automated edge detection contouring-thresholding technique. Partial correlation analysis controlling for age and age of MS onset was used to assess the relationship between age of menarche and MRI measures. Results were considered statistically significant at p< 0.05.
Results: The mean age of the group was 47.3 years (SD=10.9), median Expanded Disability Status Scale (EDSS) of 3 (IQR=2-5.5), mean disease duration of 15.2 years (SD=10.1) and mean menarche age of 12.7 years (SD=1.7). Later menarche onset showed significant correlation with increased T1-LV (r=0.13, p=0.035) and T1-LN (r=0.16, p=0.009). Later menarche onset also correlated with larger vCSF volume (r=0.15, p=0.012) and with smaller caudate (r= -0.15, p=0.01), globus pallidus
(r= -0.13, p=0.032) and total deep GM (r= -0.13, p=0.037) volumes. Age at menarche onset was not associated with EDSS.
Conclusion: Later age of menarche is associated with worse neurodegenerative MRI outcomes. Hormonal factors may influence disease progression and further studies need to corroborate our findings.
Disclosure:
Dejan Jakimovski, Deepa P. Ramasamy and Niels Bergsland have nothing to disclose.
Bianca Weinstock-Guttman received honoraria as a speaker and as a consultant for Biogen Idec,Teva Pharmaceuticals, EMD Serono, Genzyme&Sanofi, Novartis and Acorda. Dr Weinstock-Guttman received research funds from Biogen Idec, Teva Pharmaceuticals, EMD Serono, Genzyme&Sanofi, Novartis, Acorda.
Robert Zivadinov received personal compensation from Teva Pharmaceuticals, Biogen Idec, EMD Serono, Genzyme-Sanofi, Claret Medical, IMS Health and Novartis for speaking and consultant fees. He received financial support for research activities from Teva Pharmaceuticals, Genzyme-Sanofi, Novartis, Claret Medical, Intekrin-Coherus and IMS Health.
Abstract: P325
Type: Poster
Abstract Category: Clinical aspects of MS - MS and gender
Background: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS). During the last decades, the prevalence ratio of women to men has notably increased (2-3:1). This may be attributed to hormonal, genetic and lifestyle differences between genders. Female life span is marked by several hormonal changes starting from menarche, through child bearing years, ending with menopause. The effect of hormonal changes on MRI outcome measures in MS patients is still poorly understood.
Objective: To investigate the effect of different age of menarche on MS inflammatory and neurodegenerative MRI outcome measures.
Methods: This study utilized data from an ongoing prospective Cardiovascular, Environmental, Genetic (CEG) study. 276 female MS patients who underwent full clinical examination, MRI assessment on 3T MRI scanner and completed an epidemiological questionnaire regarding reproductive history were selected. Grey matter (GM) volume, white matter (WM) volume, cortical volume and ventricular cerebrospinal fluid (vCSF) volume were calculated using SIENAX cross-sectional software. Volumes of total deep grey matter, thalamus, caudate nucleus, putamen, globus pallidus and hippocampus were measured using fMRIB"s Integrated Registration and Segmentation Tool (FIRST) software. T2-, T1- and gadolinium- (Gd) lesion volumes (LV) and lesion numbers (LN) were calculated using a reliable semi-automated edge detection contouring-thresholding technique. Partial correlation analysis controlling for age and age of MS onset was used to assess the relationship between age of menarche and MRI measures. Results were considered statistically significant at p< 0.05.
Results: The mean age of the group was 47.3 years (SD=10.9), median Expanded Disability Status Scale (EDSS) of 3 (IQR=2-5.5), mean disease duration of 15.2 years (SD=10.1) and mean menarche age of 12.7 years (SD=1.7). Later menarche onset showed significant correlation with increased T1-LV (r=0.13, p=0.035) and T1-LN (r=0.16, p=0.009). Later menarche onset also correlated with larger vCSF volume (r=0.15, p=0.012) and with smaller caudate (r= -0.15, p=0.01), globus pallidus
(r= -0.13, p=0.032) and total deep GM (r= -0.13, p=0.037) volumes. Age at menarche onset was not associated with EDSS.
Conclusion: Later age of menarche is associated with worse neurodegenerative MRI outcomes. Hormonal factors may influence disease progression and further studies need to corroborate our findings.
Disclosure:
Dejan Jakimovski, Deepa P. Ramasamy and Niels Bergsland have nothing to disclose.
Bianca Weinstock-Guttman received honoraria as a speaker and as a consultant for Biogen Idec,Teva Pharmaceuticals, EMD Serono, Genzyme&Sanofi, Novartis and Acorda. Dr Weinstock-Guttman received research funds from Biogen Idec, Teva Pharmaceuticals, EMD Serono, Genzyme&Sanofi, Novartis, Acorda.
Robert Zivadinov received personal compensation from Teva Pharmaceuticals, Biogen Idec, EMD Serono, Genzyme-Sanofi, Claret Medical, IMS Health and Novartis for speaking and consultant fees. He received financial support for research activities from Teva Pharmaceuticals, Genzyme-Sanofi, Novartis, Claret Medical, Intekrin-Coherus and IMS Health.