Contributions
Abstract: P477
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: The number and volume of white mater intracranial lesions explain only a fraction of the diversity of clinical outcomes in multiple sclerosis (MS). Little is known about brain and spinal cord volume in MS patients with pronounced dissociation between intracranial lesion load (LL) and disability.
Objective: To explore regional brain volumes and spinal cord volume in MS patients with dissociation between LL and disability.
Methods: Similarly to Healy et al., we assigned 1245 relapsing-remitting MS patients into three groups based on the clinical disability and cerebral white matter LL (estimated by FreeSurfer). The first group consisted of patients with low LL, but high disability (LL < 3 ml, EDSS ≥ 3.5). The second group represented patients low disability despite high LL (LL > 6 ml, EDSS ≤ 1.5). The remaining MS patients were considered "nonparadox". We compared global and regional brain volumes (gray and white matter, lateral ventricles, cortex, thalamus, cerebellum and corpus callosum normalized by total intracranial volume) estimated automatically by MorphoBox prototype and raw mean upper cervical cord area (MUCCA) measured semiautomatically by ScanView software between the three groups (overall and separately for men and women) by using ANOVA or Kruskal-Wallis test respectively.
Results: Patients with low LL, but high disability (n= 53; 46 female, mean age 43.33±10.62 years, mean disease duration 11.25±7.0 years, median EDSS 4.0) demonstrated significantly higher total brain volume, thalamus and corpus callosum volume and smaller lateral ventricles volume than those with low disability despite high LL (n=71; 42 female, mean age 38.26±9.61 years, disease duration 11.18±8.13 years, median EDSS 1.5). Thalamus volume was higher and lateral ventricles volume was lower in patients with low LL, but high disability than in nonparadox patients (n= 1121; 801 female, mean age 40.40±9.55 years, disease duration 11.06±7.66 years, median EDSS 2.0). Besides this, we found no other difference in brain volumes between these two groups. Importantly, patients with low LL, but high disability had significantly lower MUCCA (80.39±8.44 mm2) than both remaining groups (low disability despite high LL 85.75 mm2±7.58 mm2 and nonparadox 84.02±9.82 mm2).
Conclusion: Reduced spinal cord volume may explain part of the clinical-radiological paradox in patients who have high disability despite low intracranial lesion load.
Disclosure: The project was realized with support of RVO-VFN64165, grant NV18-04-00168.
Michaela Andelova received financial support for conference travel from Novartis, Merck Serono, Genzyme and Biogen Idec.
Jan Krasensky received research funding from Biogen Idec.
Tomas Uher received financial support for conference travel and honoraria from Biogen Idec, Roche, Novartis, Genzyme and Merck Serono.
Eliska Kusova has nothing to disclose.
Barbora Benova received compensation for travelling and conference fees from Novartis and Sanofi Genzyme and Biogen Idec.
Lucie Kadrnozkova received compensation for travelling from Roche.
Karolina Kucerova has nothing to disclose.
Jiri Motyl has nothing to disclose.
Eva Havrdova received speaker honoraria and consultant fees from Biogen Idec, Merck Serono, Novartis, Genzyme and Teva, as well as support for research activities from Biogen Idec and Merck Serono.
Manuela Vaneckova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis and Sanofi Genzyme, as well as support for research activities from Biogen Idec.
Dana Horakova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck, Bayer, Sanofi Genzyme, and Teva, as well as support for research activities from Biogen Idec.
Abstract: P477
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: The number and volume of white mater intracranial lesions explain only a fraction of the diversity of clinical outcomes in multiple sclerosis (MS). Little is known about brain and spinal cord volume in MS patients with pronounced dissociation between intracranial lesion load (LL) and disability.
Objective: To explore regional brain volumes and spinal cord volume in MS patients with dissociation between LL and disability.
Methods: Similarly to Healy et al., we assigned 1245 relapsing-remitting MS patients into three groups based on the clinical disability and cerebral white matter LL (estimated by FreeSurfer). The first group consisted of patients with low LL, but high disability (LL < 3 ml, EDSS ≥ 3.5). The second group represented patients low disability despite high LL (LL > 6 ml, EDSS ≤ 1.5). The remaining MS patients were considered "nonparadox". We compared global and regional brain volumes (gray and white matter, lateral ventricles, cortex, thalamus, cerebellum and corpus callosum normalized by total intracranial volume) estimated automatically by MorphoBox prototype and raw mean upper cervical cord area (MUCCA) measured semiautomatically by ScanView software between the three groups (overall and separately for men and women) by using ANOVA or Kruskal-Wallis test respectively.
Results: Patients with low LL, but high disability (n= 53; 46 female, mean age 43.33±10.62 years, mean disease duration 11.25±7.0 years, median EDSS 4.0) demonstrated significantly higher total brain volume, thalamus and corpus callosum volume and smaller lateral ventricles volume than those with low disability despite high LL (n=71; 42 female, mean age 38.26±9.61 years, disease duration 11.18±8.13 years, median EDSS 1.5). Thalamus volume was higher and lateral ventricles volume was lower in patients with low LL, but high disability than in nonparadox patients (n= 1121; 801 female, mean age 40.40±9.55 years, disease duration 11.06±7.66 years, median EDSS 2.0). Besides this, we found no other difference in brain volumes between these two groups. Importantly, patients with low LL, but high disability had significantly lower MUCCA (80.39±8.44 mm2) than both remaining groups (low disability despite high LL 85.75 mm2±7.58 mm2 and nonparadox 84.02±9.82 mm2).
Conclusion: Reduced spinal cord volume may explain part of the clinical-radiological paradox in patients who have high disability despite low intracranial lesion load.
Disclosure: The project was realized with support of RVO-VFN64165, grant NV18-04-00168.
Michaela Andelova received financial support for conference travel from Novartis, Merck Serono, Genzyme and Biogen Idec.
Jan Krasensky received research funding from Biogen Idec.
Tomas Uher received financial support for conference travel and honoraria from Biogen Idec, Roche, Novartis, Genzyme and Merck Serono.
Eliska Kusova has nothing to disclose.
Barbora Benova received compensation for travelling and conference fees from Novartis and Sanofi Genzyme and Biogen Idec.
Lucie Kadrnozkova received compensation for travelling from Roche.
Karolina Kucerova has nothing to disclose.
Jiri Motyl has nothing to disclose.
Eva Havrdova received speaker honoraria and consultant fees from Biogen Idec, Merck Serono, Novartis, Genzyme and Teva, as well as support for research activities from Biogen Idec and Merck Serono.
Manuela Vaneckova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis and Sanofi Genzyme, as well as support for research activities from Biogen Idec.
Dana Horakova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck, Bayer, Sanofi Genzyme, and Teva, as well as support for research activities from Biogen Idec.