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Mult Scler. 2018 May;24(6):721-727. doi: 10.1177/1352458517707070. Epub 2017 Apr 26.

Brain atrophy 15 years after CIS: Baseline and follow-up clinico-radiological correlations.

Author information

1
Department of Neurology-Neuroimmunology and Multiple Sclerosis Centre of Catalonia (Cemcat), Edifici Cemcat, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
2
Section of Neuroradiology and Magnetic Resonance Unit, Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
3
Department of Neurology-Neuroimmunology and Multiple Sclerosis Centre of Catalonia (Cemcat), Edifici Cemcat, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain/National Hospital for Neurology and Neurosurgery, Queen Square MS Centre, UCL Institute of Neurology, London, UK.

Abstract

BACKGROUND:

Brain atrophy in multiple sclerosis (MS) patients is present since the very early stages of the disease and it has been related to long-term disability.

OBJECTIVE:

To estimate brain volume (BV) at 15 years after a clinically isolated syndrome (CIS) and to evaluate its relationship with disease outcomes.

METHODS:

From a prospective cohort including patients presenting with a CIS, 54 patients with a brain magnetic resonance imaging (MRI) performed 15 years after CIS were included. Brain parenchymal fraction (BPF), grey matter fraction (GMF) and white matter fraction (WMF) at 15-year follow-up were obtained. Regression analyses were conducted to predict BV loss and reaching an Expanded Disability Status Scale (EDSS) of 3.0 in that 15-year period.

RESULTS:

In multivariable analyses, lower values of BPF and WMF were significantly associated with being male, presenting 3-4 Barkhof criteria at baseline, presenting a second relapse, and with a decision to start treatment. In the multivariable logistic regression analysis, only lower GMF was associated with a greater risk of reaching EDSS 3.0 (odds ratio (OR) = 0.24, p = 0.028).

CONCLUSION:

Lower BPF and WMF 15 years after CIS are associated with previous markers of inflammatory disease. Lower GMF 15 years after a CIS is associated with an increased risk of reaching an EDSS of 3.0.

KEYWORDS:

Multiple sclerosis; atrophy; clinically isolated syndrome; grey matter

PMID:
28445084
DOI:
10.1177/1352458517707070

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