Patients’ Stratification and Correlation of Brain Magnetic Resonance Imaging Parameters with Disability Progression in Multiple Sclerosis

Vaněčková, Manuela; Seidl, Zdeněk; Krásenský, Jan; Havrdová, Eva; Horáková, Dana; Doležal, Ondřej; Burgetová, Andrea; Mašek, Martin

doi:10.1159/000206852

Cited by 8 publications

(8 citation statements)

References 52 publications

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“…Considering the fact that excessive iron accumulation in the basal ganglia represents a neurodegenerative component of MS disease [7,33] and the observed strong correlations with gray matter atrophy, this study supports our hypothesis of patient stratification in those with mostly inflammatory components and in those with mostly degenerative components [34]; if we are not able to explain the identical disability status (disease manifestation) by corresponding MRI T 2 (or FLAIR) plaques, we could explain it as neurodegenerative changes (T 2 shortening, BPF). Our results are further evidence of the multifactorial etiology of MS and also that neurodegenerative changes play an important role in the etiology of disease.…”

Section: Discussionsupporting

confidence: 82%

Multiple Sclerosis and the Accumulation of Iron in the Basal Ganglia: Quantitative Assessment of Brain Iron Using MRI T<sub>2</sub> Relaxometry

Burgetová¹,

Seidl²,

Krásenský³

et al. 2010

Eur Neurol

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The aim of this work was to quantify the accumulation of iron in the basal ganglia in multiple sclerosis (MS) patients and in a control group, and to investigate the relationship between iron accumulation and other parameters assessed in MS, i.e. lesion load (LL) and brain parenchymal fraction (BPF). Magnetic resonance imaging T₂ relaxometry was used for the measurement. 970 patients with clinically definite MS and 117 controls were examined. Patients were divided into three subgroups according to LL and BPF. This work provides quantitative evidence of increased iron accumulation in the basal ganglia in MS patients in comparison to healthy controls. We also found that in the subgroup with small LL value, iron accumulation is higher than in the subgroup with large LL value. The hypothesis of a neurodegenerative component of MS is supported by the changes in iron content in the brain.

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Section: Discussionsupporting

confidence: 82%

Multiple Sclerosis and the Accumulation of Iron in the Basal Ganglia: Quantitative Assessment of Brain Iron Using MRI T<sub>2</sub> Relaxometry

Burgetová¹,

Seidl²,

Krásenský³

et al. 2010

Eur Neurol

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“…The two remaining longitudinal studies evaluated the predictive value of baseline brain volume and T2 lesion load for subsequent disability. In a 5-year study in patients with RRMS, Vaneckova et al demonstrated a significant correlation between increased brain atrophy in the first 2 years and EDSS score increase at years 4 and 5 in patients with a low lesion load at baseline ( p < 0.01); this correlation was not observed for those with a high baseline lesion burden ( 65 ). In another study, the probability of sustained disability progression (an EDSS score ≥3 within 3 years) was almost five times higher in patients with a low brain volume and a high T2 lesion volume compared with patients with a high brain volume and low T2 lesion volume ( 71 ).…”

Section: Resultsmentioning

confidence: 98%

The Role of T1-Weighted Derived Measures of Neurodegeneration for Assessing Disability Progression in Multiple Sclerosis

2017

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IntroductionMultiple sclerosis (MS) is characterised by the accumulation of permanent neurological disability secondary to irreversible tissue loss (neurodegeneration) in the brain and spinal cord. MRI measures derived from T1-weighted image analysis (i.e., black holes and atrophy) are correlated with pathological measures of irreversible tissue loss. Quantifying the degree of neurodegeneration in vivo using MRI may offer a surrogate marker with which to predict disability progression and the effect of treatment. This review evaluates the literature examining the association between MRI measures of neurodegeneration derived from T1-weighted images and disability in MS patients.MethodsA systematic PubMed search was conducted in January 2017 to identify MRI studies in MS patients investigating the relationship between “black holes” and/or atrophy in the brain and spinal cord, and disability. Results were limited to human studies published in English in the previous 10 years.ResultsA large number of studies have evaluated the association between the previous MRI measures and disability. These vary considerably in terms of study design, duration of follow-up, size, and phenotype of the patient population. Most, although not all, have shown that there is a significant correlation between disability and black holes in the brain, as well as atrophy of the whole brain and grey matter. The results for brain white matter atrophy are less consistently positive, whereas studies evaluating spinal cord atrophy consistently showed a significant correlation with disability. Newer ways of measuring atrophy, thanks to the development of segmentation and voxel-wise methods, have allowed us to assess the involvement of strategic regions of the CNS (e.g., thalamus) and to map the regional distribution of damage. This has resulted in better correlations between MRI measures and disability and in the identification of the critical role played by some CNS structures for MS clinical manifestations.ConclusionThe evaluation of MRI measures of atrophy as predictive markers of disability in MS is a highly active area of research. At present, measurement of atrophy remains within the realm of clinical studies, but its utility in clinical practice has been recognized and barriers to its implementation are starting to be addressed.

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“…Our own automated software (ScanViewCZ, designed by J.K.) was used to quantify T 2 LV in the FLAIR sequences and T 1 LV, brain atrophy and BPF in the T 1 -weighted 3D sequences [for detailed protocols, see [9], [10]]. Corpus callosum was measured on T 1 -weighted 3D images, using reconstructions of the sagittal slices.…”

Section: Methodsmentioning

confidence: 99%

Corpus Callosum Atrophy – A Simple Predictor of Multiple Sclerosis Progression: A Longitudinal 9-Year Study

Vaněčková¹,

Kalinčík

Krásenský³

et al. 2012

Eur Neurol

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Aim: To determine whether corpus callosum atrophy predicts future clinical deterioration in multiple sclerosis. Methods: In 39 multiple sclerosis patients the area of corpus callosum in the sagittal plane, T₂ and T₁ lesion volumes, brain parenchymal fraction and brain atrophy were determined at baseline and 1 year after treatment initiation. Non-parametric and multiple regression models were built to identify the most reliable predictors of disability and of its changes over 9 years. Results: Corpus callosum atrophy during the first year of treatment was the best predictor of disability (r = –0.56) and of its increase at 9 years (r = 0.65). Corpus callosum atrophy of at least 2% predicted increase in disability with 93% sensitivity and 73% specificity (odds ratio = 35). Conclusion: Corpus callosum atrophy is a simple and accurate predictor of future disability accumulation and is feasible for routine clinical practice.

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Patients’ Stratification and Correlation of Brain Magnetic Resonance Imaging Parameters with Disability Progression in Multiple Sclerosis

Cited by 8 publications

References 52 publications

Multiple Sclerosis and the Accumulation of Iron in the Basal Ganglia: Quantitative Assessment of Brain Iron Using MRI T<sub>2</sub> Relaxometry

Multiple Sclerosis and the Accumulation of Iron in the Basal Ganglia: Quantitative Assessment of Brain Iron Using MRI T<sub>2</sub> Relaxometry

The Role of T1-Weighted Derived Measures of Neurodegeneration for Assessing Disability Progression in Multiple Sclerosis

Corpus Callosum Atrophy – A Simple Predictor of Multiple Sclerosis Progression: A Longitudinal 9-Year Study

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