Central nervous system atrophy predicts future dynamics of disability progression in a real-world multiple sclerosis cohort.

TitleCentral nervous system atrophy predicts future dynamics of disability progression in a real-world multiple sclerosis cohort.
Publication TypeJournal Article
Year of Publication2021
AuthorsTsagkas C, Naegelin Y, Amann M, Papadopoulou A, Barro C, Chakravarty MM, Gaetano L, Wuerfel J, Kappos L, Kuhle J, Granziera C, Sprenger T, Magon S, Parmar K
JournalEur J Neurol
Volume28
Issue12
Pagination4153-4166
Date Published2021 Dec
ISSN1468-1331
Abstract

BACKGROUND AND PURPOSE: In an era of individualized multiple sclerosis (MS) patient management, biomarkers for accurate prediction of future clinical outcomes are needed. We aimed to evaluate the potential of short-term magnetic resonance imaging (MRI) atrophy measures and serum neurofilament light chain (sNfL) as predictors of the dynamics of disability accumulation in relapse-onset MS.METHODS: Brain gray and white matter, thalamic, striatal, pallidal and cervical spinal cord volumes, and lesion load were measured over three available time points (mean time span 2.24 ± 0.70 years) for 183 patients (140 relapsing-remitting [RRMS] and 43 secondary-progressive MS (SPMS); 123 female, age 46.4 ± 11.0 years; disease duration 15.7 ± 9.3 years), and their respective annual changes were calculated. Baseline sNfL was also measured at the third available time point for each patient. Subsequently, patients underwent annual clinical examinations over 5.4 ± 3.7 years including Expanded Disability Status Scale (EDSS) scoring, the nine-hole peg test and the timed 25-foot walk test.RESULTS: Higher annual spinal cord atrophy rates and lesion load increase predicted higher future EDSS score worsening over time in SPMS. Lower baseline thalamic volumes predicted higher walking speed worsening over time in RRMS. Lower baseline gray matter, as well as higher white matter and spinal cord atrophy rates, lesion load increase, baseline striatal volumes and baseline sNfL, predicted higher future hand dexterity worsening over time. All models showed reasonable to high prediction accuracy.CONCLUSION: This study demonstrates the capability of short-term MRI metrics to accurately predict future dynamics of disability progression in a real-world relapse-onset MS cohort. The present study represents a step towards the utilization of structural MRI measurements in patient care.

DOI10.1111/ene.15098
Alternate JournalEur J Neurol
PubMed ID34487400
Grant ListE!113682 / / H2020 European Research Council /
3MS1020 / / Universität Basel /
3MS1049 / / Universität Basel /
320030_156860 / / Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung /
P400PM_191077 / / Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung /
PP00P3_176984 / / Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung /
/ / Stiftung zur Förderung der gastroenterologischen und allgemeinen klinischen Forschung /