A better MR marker for disability progression in MS

A better MR marker for disability progression in MS

Press releases may be edited for formatting or style | September 25, 2019 Alzheimers/Neurology MRI
BUFFALO, N.Y. — A retrospective, five-year study of 1,314 patients with multiple sclerosis (MS) has found that atrophied brain lesion volume is the only marker from MRI scans that can accurately predict which patients will progress to the most severe form of the disease.

Secondary progressive MS, known as SPMS, typically appears 10 to 20 years after the initial onset and causes patients to become more physically and cognitively impaired.

Of the 1,314 patients in the study, published September 24 in Radiology, more than 1,000 were women with an average age of 46.

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The study, by researchers in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, builds on previous work they did that determined that atrophied brain lesion volume was a better indicator of disease progression than the appearance of lesions or whole brain atrophy, both of which have long been used as predictors of disease progression.

Predicting disease progression

“This study corroborates initial reports from our group regarding using atrophied lesion volume as a potential MRI marker of disease progression in a large, population-based cohort of MS patients followed in clinical routine,” said Robert Zivadinov, MD, PhD, professor of neurology in the Jacobs School, director of its Buffalo Neuroimaging Analysis Center (BNAC) and director of the Center for Biomedical Imaging at UB’s Clinical and Translational Science Institute.

As part of their routine care, patients undergo MRI scans regularly, so that physicians can monitor new lesions or increased atrophy, which they see as indicators of more disease, or check for any reduction in lesions, generally seen as an indication that medications are working. Getting a new MS drug approved by the Food and Drug Administration requires, among other things, the ability of the new drug to reduce the number of brain lesions a patient has over 24 months.

But the UB research demonstrates that it is the atrophied brain lesion volume, which results from disintegration of lesions, and not creation of new lesions or progression of brain atrophy, that more accurately signals progression of the disease.

“Neither changes in number and volume of lesions nor the development of whole brain or central brain atrophy showed any predictive power in demonstrating which patients would progress to secondary progressive MS, either from initial presentation of the disease, called clinically isolated syndrome, or the next stage, relapsing remitting MS,” said Zivadinov.

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