Brain Advance Access originally published online on August 22, 2003
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Brain, Vol. 126, No. 10, 2323-2332,
October 2003
© 2003 Guarantors of Brain
doi: 10.1093/brain/awg232
Conventional and magnetization transfer MRI predictors of clinical multiple sclerosis evolution: a medium-term follow-up study
1 Neuroimaging Research Unit and 2 Clinical Trial Unit, Department of Neuroscience, Scientific Institute and University Ospedale San Raffaele, Milan, Italy
Correspondence to: Dr Massimo Filippi, Neuroimaging Research Unit, Department of Neuroscience, Scientific Institute and University Ospedale San Raffaele, via Olgettina, 60, 20132 Milan, Italy E-mail: filippi.massimo{at}hsr.it
The correlation between conventional MRI lesion load accumulation and multiple sclerosis clinical evolution is only modest. The assessment of brain parenchymal volume and of its changes over time may provide adjunctive MRI markers reflecting the more disabling aspects of multiple sclerosis pathology. Magnetization transfer (MT) MRI is sensitive to ‘occult’ multiple sclerosis-related brain damage and might also contribute to overcome the clinical/MRI paradox. In this study, we assessed the value of conventional and MT MRI-derived metrics in predicting the medium-term clinical evolution of patients with different multiple sclerosis phenotypes. We studied 73 patients, with relapsing–remitting multiple sclerosis (n = 34), secondary progressive multiple sclerosis (n = 19) and clinically isolated syndromes suggestive of multiple sclerosis (n = 20), and 16 healthy subjects. Brain dual-echo, T1-weighted (only in patients) and MT MRI scans were obtained at baseline and after 12 months. T2-hyperintense and T1-hypointense lesion volumes, normalized brain volume and average lesion MT ratio (MTR) were measured. MTR histograms from the whole brain tissue were also obtained. Clinical multiple sclerosis evolution and neurological disability were re-assessed in all patients after a median follow-up of 4.5 years. A multivariate analysis was performed to establish which clinical and MRI-derived variables were significant predictors of neurological deterioration at the end of the study period. At the end of follow-up, 34 patients showed significant neurological deterioration. The final multivariable model included average brain MTR percentage change after one year [P = 0.02, odds ratio (OR) = 0.86] and baseline T2-hyperintense lesion volume (P = 0.04, OR=1.04) as independent predictors of medium-term disability accumulation (r2 = 0.23). In this cohort of patients, abnormal values of average brain MTR changes showed a relatively high specificity (76.9%) and positive predictive value (59.1%) for Expanded Disability Status Scale score deterioration in individual cases. In patients with multiple sclerosis, a comprehensive estimation of the short-term changes of both conventional and MT MRI-detectable lesion burden might provide useful prognostic information for the medium-term clinical disease evolution.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  L. Fisniku, D. Altmann, M Cercignani, D. Tozer, D. Chard, J. Jackson, K. Miszkiel, K Schmierer, A. Thompson, and D. Miller Magnetization transfer ratio abnormalities reflect clinically relevant grey matter damage in multiple sclerosis Multiple Sclerosis, June 1, 2009; 15(6): 668 - 677. [Abstract] [PDF]
|
|
|
|
 |
|
 Z. Khaleeli, D. R. Altmann, M. Cercignani, O. Ciccarelli, D. H. Miller, and A. J. Thompson Magnetization Transfer Ratio in Gray Matter: A Potential Surrogate Marker for Progression in Early Primary Progressive Multiple Sclerosis Arch Neurol, November 1, 2008; 65(11): 1454 - 1459. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A Minneboo, B Jasperse, F Barkhof, B M J Uitdehaag, D L Knol, V de Groot, C H Polman, and J A Castelijns Predicting short-term disability progression in early multiple sclerosis: added value of MRI parameters J. Neurol. Neurosurg. Psychiatry, August 1, 2008; 79(8): 917 - 923. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Pascual, M. C. Martinez-Bisbal, I. Bosca, C. Valero, F. Coret, B. Martinez-Granados, L. Marti-Bonmati, A. Mir, B. Celda, and B. Casanova Axonal loss is progressive and partly dissociated from lesion load in early multiple sclerosis Neurology, July 3, 2007; 69(1): 63 - 67. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Khan Can clinical outcomes be used to detect neuroprotection in multiple sclerosis? Neurology, May 29, 2007; 68(22_suppl_3): S64 - S71. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Zivadinov Can imaging techniques measure neuroprotection and remyelination in multiple sclerosis? Neurology, May 29, 2007; 68(22_suppl_3): S72 - S82. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Rovaris, G. Comi, M. Rocca, P. Valsasina, D. Ladkani, E. Pieri, S. Weiss, G. Shifroni, J. Wolinsky, M. Filippi, et al. Long-term follow-up of patients treated with glatiramer acetate: a multicentre, multinational extension of the European/Canadian double-blind, placebo-controlled, MRI-monitored trial Multiple Sclerosis, May 1, 2007; 13(4): 502 - 508. [Abstract] [PDF]
|
|
|
|
|
|
G R Davies, A Hadjiprocopis, D R Altmann, D T Chard, C M Griffin, W Rashid, G J Parker, P S Tofts, R Kapoor, A J Thompson, et al. Normal-appearing grey and white matter T1 abnormality in early relapsing-remitting multiple sclerosis: a longitudinal study Multiple Sclerosis, March 1, 2007; 13(2): 169 - 177. [Abstract] [PDF]
|
|
|
|
|
|
L Lopatinskaya, J Zwemmer, B Uitdehaag, K Lucas, C Polman, and L Nagelkerken Mediators of apoptosis Fas and FasL predict disability progression in multiple sclerosis over a period of 10 years Multiple Sclerosis, November 1, 2006; 12(6): 704 - 709. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Ramani, J. H. Jensen, and J. A. Helpern Quantitative MR Imaging in Alzheimer Disease Radiology, October 1, 2006; 241(1): 26 - 44. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Rovaris, E. Judica, A. Gallo, B. Benedetti, M. P. Sormani, D. Caputo, A. Ghezzi, E. Montanari, A. Bertolotto, G. Mancardi, et al. Grey matter damage predicts the evolution of primary progressive multiple sclerosis at 5 years Brain, October 1, 2006; 129(10): 2628 - 2634. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Agosta, M. Rovaris, E. Pagani, M. P. Sormani, G. Comi, and M. Filippi Magnetization transfer MRI metrics predict the accumulation of disability 8 years later in patients with multiple sclerosis Brain, October 1, 2006; 129(10): 2620 - 2627. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L Leocani, M Rovaris, F M Boneschi, S Medaglini, P Rossi, V Martinelli, S Amadio, and G Comi Multimodal evoked potentials to assess the evolution of multiple sclerosis: a longitudinal study J. Neurol. Neurosurg. Psychiatry, September 1, 2006; 77(9): 1030 - 1035. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. De Stefano, M. Battaglini, M. L. Stromillo, V. Zipoli, M. L. Bartolozzi, L. Guidi, G. Siracusa, E. Portaccio, A. Giorgio, S. Sorbi, et al. Brain damage as detected by magnetization transfer imaging is less pronounced in benign than in early relapsing multiple sclerosis Brain, August 1, 2006; 129(8): 2008 - 2016. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Oreja-Guevara, A. Charil, D. Caputo, R. Cavarretta, M. P. Sormani, and M. Filippi Magnetization transfer magnetic resonance imaging and clinical changes in patients with relapsing-remitting multiple sclerosis. Arch Neurol, May 1, 2006; 63(5): 736 - 740. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. T. M. Fernando, D. J. Tozer, K. A. Miszkiel, R. M. Gordon, J. K. Swanton, C. M. Dalton, G. J. Barker, G. T. Plant, A. J. Thompson, and D. H. Miller Magnetization transfer histograms in clinically isolated syndromes suggestive of multiple sclerosis Brain, December 1, 2005; 128(12): 2911 - 2925. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Rovaris, A. Gambini, A. Gallo, A. Falini, A. Ghezzi, B. Benedetti, M. P. Sormani, V. Martinelli, G. Comi, and M. Filippi Axonal injury in early multiple sclerosis is irreversible and independent of the short-term disease evolution Neurology, November 22, 2005; 65(10): 1626 - 1630. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Gallo, M. Rovaris, R. Riva, A. Ghezzi, B. Benedetti, V. Martinelli, A. Falini, G. Comi, and M. Filippi Diffusion-Tensor Magnetic Resonance Imaging Detects Normal-Appearing White Matter Damage Unrelated to Short-term Disease Activity in Patients at the Earliest Clinical Stage of Multiple Sclerosis Arch Neurol, May 1, 2005; 62(5): 803 - 808. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Oreja-Guevara, M. Rovaris, G. Iannucci, P. Valsasina, D. Caputo, R. Cavarretta, M. P. Sormani, P. Ferrante, G. Comi, and M. Filippi Progressive Gray Matter Damage in Patients With Relapsing-Remitting Multiple Sclerosis: A Longitudinal Diffusion Tensor Magnetic Resonance Imaging Study Arch Neurol, April 1, 2005; 62(4): 578 - 584. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-P. Ranjeva, B. Audoin, M. Van Au Duong, D. Ibarrola, S. Confort-Gouny, I. Malikova, E. Soulier, P. Viout, A. Ali-Cherif, J. Pelletier, et al. Local Tissue Damage Assessed with Statistical Mapping Analysis of Brain Magnetization Transfer Ratio: Relationship with Functional Status of Patients in the Earliest Stage of Multiple Sclerosis AJNR Am. J. Neuroradiol., January 1, 2005; 26(1): 119 - 127. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Rizvi and M. A. Agius Current approved options for treating patients with multiple sclerosis Neurology, December 28, 2004; 63(12_suppl_6): S8 - S14. [Abstract] [Full Text]
|
|
|
|
|
|
M Symms, H R Jager, K Schmierer, and T A Yousry A review of structural magnetic resonance neuroimaging J. Neurol. Neurosurg. Psychiatry, September 1, 2004; 75(9): 1235 - 1244. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. M. Boneschi, M. Rovaris, G. Comi, and M. Filippi The use of magnetic resonance imaging in multiple sclerosis: lessons learned from clinical trials Multiple Sclerosis, August 1, 2004; 10(4): 341 - 347. [Abstract] [PDF]
|
|
|
|
|
|
K. T. M. Fernando, M. A. McLean, D. T. Chard, D. G. MacManus, C. M. Dalton, K. A. Miszkiel, R. M. Gordon, G. T. Plant, A. J. Thompson, and D. H. Miller Elevated white matter myo-inositol in clinically isolated syndromes suggestive of multiple sclerosis Brain, June 1, 2004; 127(6): 1361 - 1369. [Abstract] [Full Text] [PDF]
|
|