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J Neurol. 2015 Nov;262(11):2425-32. doi: 10.1007/s00415-015-7853-x. Epub 2015 Jul 24.

Brain MRI lesions and atrophy are associated with employment status in patients with multiple sclerosis.

Author information

1
Laboratory for Neuroimaging Research, Department of Neurology, Partners MS Center, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
2
Novartis Pharmaceuticals, East Hanover, NJ, USA.
3
Analysis Group, Inc., Boston, MA, USA.
4
Laboratory for Neuroimaging Research, Department of Neurology, Partners MS Center, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA. rbakshi@post.harvard.edu.
5
Laboratory for Neuroimaging Research, Department of Radiology, Partners MS Center, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA. rbakshi@post.harvard.edu.
6
Laboratory for Neuroimaging Research, One Brookline Place, Brookline, MA, 02445, USA. rbakshi@post.harvard.edu.

Abstract

Multiple sclerosis (MS) commonly affects occupational function. We investigated the link between brain MRI and employment status. Patients with MS (n = 100) completed a Work Productivity and Activity Impairment (WPAI) (general health version) survey measuring employment status, absenteeism, presenteeism, and overall work and daily activity impairment. Patients "working for pay" were considered employed; "temporarily not working but looking for work," "not working or looking for work due to age," and "not working or looking for work due to disability" were considered not employed. Brain MRI T1 hypointense (T1LV) and T2 hyperintense (T2LV) lesion volumes were quantified. To assess lesional destructive capability, we calculated each subject's ratio of T1LV to T2LV (T1/T2). Normalized brain parenchymal volume (BPV) assessed brain atrophy. The mean (SD) age was 45.5 (9.7) years; disease duration was 12.1 (8.1) years; 75 % were women, 76 % were relapsing-remitting, and 76 % were employed. T1LV, T1/T2, Expanded Disability Status Scale (EDSS) scores, and activity impairment were lower and BPV was higher in the employed vs. not employed group (Wilcoxon tests, p < 0.05). Age, disease duration, MS clinical subtype, and T2LV did not differ between groups (p > 0.05). In multivariable logistic regression modeling, adjusting for age, sex, and disease duration, higher T1LV predicted a lower chance of employment (p < 0.05). Pearson correlations showed that EDSS was associated with activity impairment (p < 0.05). Disease duration, age, and MRI measures were not correlated with activity impairment or other WPAI outcomes (p > 0.05). We report a link between brain atrophy and lesions, particularly lesions with destructive potential, to MS employment status.

KEYWORDS:

Brain atrophy; Brain lesions; Disability; Employment; MRI; Multiple sclerosis; Productivity

PMID:
26205635
PMCID:
PMC4639581
DOI:
10.1007/s00415-015-7853-x
[Indexed for MEDLINE]
Free PMC Article

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