Contributions
Abstract: P794
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: Accelerated regional brain (BVL) and spinal cord volume (SCV) loss are well described in MS patients. However, large sample studies investigating timing of volume loss onset and its relation to disability in multiple sclerosis (MS) patients are lacking.
Objective: To compare regional brain (BV) and spinal cord volume (SCV) in different disability groups.
Methods: We examined 1197 MS patients on a 3T MRI scanner (MAGNETOM Skyra, Siemens Healthcare, Erlangen, Germany). The MRI protocol comprised 3D-T2WI-Fat-Sat in transversal plane for SCV and 3D-MPRAGE for total brain volume (TBV). Regional BV and TBV were estimated by the fully automated FreeSurfer program. SCV was measured semi-automatically in 21 1mm slices centered at the C3/C4 intervertebral disc. Disability status was measured using the Expanded Disability Status Scale (EDSS). Patients were divided into 5 disability groups: Group 1 (EDSS 1.5), Group 2 (EDSS 2.0 to 2.5), Group 3 (EDSS 3.0 to 3.5), Group 4 (EDSS 4.0 to 4.5), and Group 5 (EDSS ≥5). Regional BV and SCV in groups 1-5 were compared with a reference group consisting of patients with minimal disability (EDSS 0-1.0). Subjects in each group were matched with a reference subgroup according to age, sex and disease duration. Comparison of total and regional BV and SCV between Groups 1-5 and reference subgroups were performed using paired t-tests, done separately for male and female.
Results: Significant volume loss (p< 0.05; given in % for female/male) was found in the cerebellum as early as Group 2 (-2.7/-4.3), and also in the male spinal cord (-5.1%); in Group 3 volume loss was found in the spinal cord (-5.6/-6.4), brainstem (-4.6/-5.2), putamen (-3.4/-6.0), pallidum (-4.7/-6.9), hippocampi (-3.2/-4.6), and cortex (-3.9/-3.1). In Groups 4 and 5, highly significant reductions up to 16% were observed for the vast majority of structures (male patients in Group 5 were not assessed due to small sample size).
Conclusions: Significant reductions of regional brain and spinal cord volumes are detectable even in patients with low clinical disability (i.e. cerebellum and spinal cord) and increase dramatically with EDSS progression. Finding an appropriate volumetric marker for each stage of multiple sclerosis has potential to improve radiological monitoring of disease burden in individual MS patients.
Disclosure: The project was supported by the Czech Ministry of Education project Progress Q27/LF1, by the Czech Ministry of Health project RVO-VFN64165, grant NV18-04-00168. 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 and Merc Serono. Michaela Andelova has received travel and conference fees support from Novartis and Biogen Idec.Jan Krasensky has received research funding from Biogen.Lukas Sobisek received financial support from Novartis.Tomas Uher received financial support for conference travel and honoraria from Biogen Idec, Roche, Novartis, Genzyme and Merck Serono. Jana Lizrova Preiningerova 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. Barbora Benova received compensation for travelling and conference fees from Novartis and Sanofi Genzyme and Biogen Idec. Zdenek Seidl has received research funding from Biogen.
Eva Kubala 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. Eliska Kusova has nothing to disclose.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 and Merc Serono.
Abstract: P794
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: Accelerated regional brain (BVL) and spinal cord volume (SCV) loss are well described in MS patients. However, large sample studies investigating timing of volume loss onset and its relation to disability in multiple sclerosis (MS) patients are lacking.
Objective: To compare regional brain (BV) and spinal cord volume (SCV) in different disability groups.
Methods: We examined 1197 MS patients on a 3T MRI scanner (MAGNETOM Skyra, Siemens Healthcare, Erlangen, Germany). The MRI protocol comprised 3D-T2WI-Fat-Sat in transversal plane for SCV and 3D-MPRAGE for total brain volume (TBV). Regional BV and TBV were estimated by the fully automated FreeSurfer program. SCV was measured semi-automatically in 21 1mm slices centered at the C3/C4 intervertebral disc. Disability status was measured using the Expanded Disability Status Scale (EDSS). Patients were divided into 5 disability groups: Group 1 (EDSS 1.5), Group 2 (EDSS 2.0 to 2.5), Group 3 (EDSS 3.0 to 3.5), Group 4 (EDSS 4.0 to 4.5), and Group 5 (EDSS ≥5). Regional BV and SCV in groups 1-5 were compared with a reference group consisting of patients with minimal disability (EDSS 0-1.0). Subjects in each group were matched with a reference subgroup according to age, sex and disease duration. Comparison of total and regional BV and SCV between Groups 1-5 and reference subgroups were performed using paired t-tests, done separately for male and female.
Results: Significant volume loss (p< 0.05; given in % for female/male) was found in the cerebellum as early as Group 2 (-2.7/-4.3), and also in the male spinal cord (-5.1%); in Group 3 volume loss was found in the spinal cord (-5.6/-6.4), brainstem (-4.6/-5.2), putamen (-3.4/-6.0), pallidum (-4.7/-6.9), hippocampi (-3.2/-4.6), and cortex (-3.9/-3.1). In Groups 4 and 5, highly significant reductions up to 16% were observed for the vast majority of structures (male patients in Group 5 were not assessed due to small sample size).
Conclusions: Significant reductions of regional brain and spinal cord volumes are detectable even in patients with low clinical disability (i.e. cerebellum and spinal cord) and increase dramatically with EDSS progression. Finding an appropriate volumetric marker for each stage of multiple sclerosis has potential to improve radiological monitoring of disease burden in individual MS patients.
Disclosure: The project was supported by the Czech Ministry of Education project Progress Q27/LF1, by the Czech Ministry of Health project RVO-VFN64165, grant NV18-04-00168. 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 and Merc Serono. Michaela Andelova has received travel and conference fees support from Novartis and Biogen Idec.Jan Krasensky has received research funding from Biogen.Lukas Sobisek received financial support from Novartis.Tomas Uher received financial support for conference travel and honoraria from Biogen Idec, Roche, Novartis, Genzyme and Merck Serono. Jana Lizrova Preiningerova 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. Barbora Benova received compensation for travelling and conference fees from Novartis and Sanofi Genzyme and Biogen Idec. Zdenek Seidl has received research funding from Biogen.
Eva Kubala 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. Eliska Kusova has nothing to disclose.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 and Merc Serono.