Contributions
Abstract: P524
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Background: While the rate of brain atrophy is accelerated in multiple sclerosis (MS) patients who develop clinical disability over time, it is unclear whether patients who experience clinical improvement have different brain atrophy trajectories, compared to progressing and stable patients. Measurement of lateral ventricular volume (LVV) was recently proposed as a robust, clinically-feasible proxy for whole brain atrophy.
Objectives: To investigate whether MS patients who improve in their clinical disability over time develop less brain atrophy compared to those who progress or remain stable.
Methods: We enrolled 1,270 MS patients over a period of 10 years (mean time of follow-up 4.6 years). We used Neurological Software Tool for REliable Atrophy Measurement (NeuroSTREAM) to measure LVV on 6,831 brain scans images (min 2, max 24, and median of 4.0 per subject). Percent LVV change (PLVVC) was determined between all-time points. Subjects were divided in 3 groups: disability progression (DP, n=355), disability improvement (DI, n=124) and stable (n=791). DP was defined as an increase from baseline Expanded Disability Status Scale (EDSS) of at least 1.0 point, or 0.5 if the baseline EDSS score was >5.5. DI was defined as a reduction from the baseline EDSS score of at least 1.0 point if the baseline score was 2.0-5.5, or 0.5 if the baseline score was >5.5. PLVVC differences between age groups were calculated using analysis of covariance, adjusted for age, disease duration and LVV at first MRI, gender, field strength and time of follow up in years.
Results: At first MRI, there were no significant LVV differences between stable, DP or DI MS patients. Over the follow-up period, the cumulative PLVVC was 9.0% in DI, 10.7% in stable and 14.8% in DP MS patients. All p values were significantly different (DP/DI/stable, p=0.014; DP/DI, p< 0.0001; DP/stable, p< 0.0001).
Conclusions: MS patients who improve in their clinical disability develop less brain atrophy over time when compared to those who progress or remain stable.
Disclosure: Study Disclosures: None.
Financial Relationships/Potential Conflicts of Interest:
Emanuele Ghione, Niels Bergsland, Jesper Hagemeier, Deepa P. Ramasamay, Dejan Jakimovski, Ivo Paunkoski and Ellen Carl have nothing to disclose.
Michael G. Dwyer has received consultant fees from Claret Medical and research grant support from Novartis.
David Hojnacki has received speaker honoraria and consultant fees from Biogen Idec, Teva Pharmaceutical Industries Ltd., EMD Serono, Pfizer Inc, and Novartis.
Channa Kolb has received speaker honoraria and consultant fees from EMD Serono, Teva Pharmaceuticals, Acorda, Novartis, Genzyme and Biogen-Idec.
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 EMD Serono, Genzyme-Sanofi, Claret Medical, Celgene and Novartis for speaking and consultant fees. He received financial support for research activities from Genzyme-Sanofi, Novartis, Claret Medical, Intekrin-Coherus and Quintiles IMS.
Abstract: P524
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Background: While the rate of brain atrophy is accelerated in multiple sclerosis (MS) patients who develop clinical disability over time, it is unclear whether patients who experience clinical improvement have different brain atrophy trajectories, compared to progressing and stable patients. Measurement of lateral ventricular volume (LVV) was recently proposed as a robust, clinically-feasible proxy for whole brain atrophy.
Objectives: To investigate whether MS patients who improve in their clinical disability over time develop less brain atrophy compared to those who progress or remain stable.
Methods: We enrolled 1,270 MS patients over a period of 10 years (mean time of follow-up 4.6 years). We used Neurological Software Tool for REliable Atrophy Measurement (NeuroSTREAM) to measure LVV on 6,831 brain scans images (min 2, max 24, and median of 4.0 per subject). Percent LVV change (PLVVC) was determined between all-time points. Subjects were divided in 3 groups: disability progression (DP, n=355), disability improvement (DI, n=124) and stable (n=791). DP was defined as an increase from baseline Expanded Disability Status Scale (EDSS) of at least 1.0 point, or 0.5 if the baseline EDSS score was >5.5. DI was defined as a reduction from the baseline EDSS score of at least 1.0 point if the baseline score was 2.0-5.5, or 0.5 if the baseline score was >5.5. PLVVC differences between age groups were calculated using analysis of covariance, adjusted for age, disease duration and LVV at first MRI, gender, field strength and time of follow up in years.
Results: At first MRI, there were no significant LVV differences between stable, DP or DI MS patients. Over the follow-up period, the cumulative PLVVC was 9.0% in DI, 10.7% in stable and 14.8% in DP MS patients. All p values were significantly different (DP/DI/stable, p=0.014; DP/DI, p< 0.0001; DP/stable, p< 0.0001).
Conclusions: MS patients who improve in their clinical disability develop less brain atrophy over time when compared to those who progress or remain stable.
Disclosure: Study Disclosures: None.
Financial Relationships/Potential Conflicts of Interest:
Emanuele Ghione, Niels Bergsland, Jesper Hagemeier, Deepa P. Ramasamay, Dejan Jakimovski, Ivo Paunkoski and Ellen Carl have nothing to disclose.
Michael G. Dwyer has received consultant fees from Claret Medical and research grant support from Novartis.
David Hojnacki has received speaker honoraria and consultant fees from Biogen Idec, Teva Pharmaceutical Industries Ltd., EMD Serono, Pfizer Inc, and Novartis.
Channa Kolb has received speaker honoraria and consultant fees from EMD Serono, Teva Pharmaceuticals, Acorda, Novartis, Genzyme and Biogen-Idec.
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 EMD Serono, Genzyme-Sanofi, Claret Medical, Celgene and Novartis for speaking and consultant fees. He received financial support for research activities from Genzyme-Sanofi, Novartis, Claret Medical, Intekrin-Coherus and Quintiles IMS.