Voxelwise analysis of conventional magnetic resonance imaging to predict future disability in early relapsing–remitting multiple sclerosis

• Published in: Multiple sclerosis 2012-11, Vol.18 (11), p.1585-1591
• Main Authors: Wybrecht, Delphine, Reuter, Françoise, Zaaraoui, Wafaa, Faivre, Anthony, Crespy, Lydie, Rico, Audrey, Malikova, Irina, Confort-Gouny, Sylviane, Soulier, Elisabeth, Cozzone, Patrick J, Pelletier, Jean, Ranjeva, Jean-Philippe, Audoin, Bertrand
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Brain - pathology; Brain - physiopathology; Cognition; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Disability Evaluation; Disease Progression; Female; Humans; Linear Models; Longitudinal Studies; Magnetic Resonance Imaging; Male; Medical sciences; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Multiple Sclerosis, Relapsing-Remitting - diagnosis; Multiple Sclerosis, Relapsing-Remitting - pathology; Multiple Sclerosis, Relapsing-Remitting - physiopathology; Multiple Sclerosis, Relapsing-Remitting - psychology; Neurology; Neuropsychological Tests; Predictive Value of Tests; Prognosis; Severity of Illness Index; Time Factors; Young Adult
• ISSN: 1352-4585; 1477-0970
• DOI: 10.1177/1352458512442991

Background: The ability of conventional magnetic resonance imaging (MRI) to predict subsequent physical disability and cognitive deterioration after a clinically isolated syndrome (CIS) is weak. Objectives: We aimed to investigate whether conventional MRI changes over 1 year could predict cognitive and physical disability 5 years later in CIS. We performed analyses using a global approach (T2 lesion load, number of T2 lesions), but also a topographic approach. Methods: This study included 38 patients with a CIS. At inclusion, 10 out of 38 patients fulfilled the 2010 revised McDonald’s criteria for the diagnosis of multiple sclerosis. Expanded Disability Status Scale (EDSS) evaluation was performed at baseline, year 1 and year 5, and cognitive evaluation at baseline and year 5. T2-weighted MRI was performed at baseline and year 1. We used voxelwise analysis to analyse the predictive value of lesions location for subsequent disability. Results: Using the global approach, no correlation was found between MRI and clinical data. The occurrence or growth of new lesions in the brainstem was correlated with EDSS changes over the 5 years of follow-up. The occurrence or growth of new lesions in cerebellum, thalami, corpus callosum and frontal lobes over 1 year was correlated with cognitive impairment at 5 years. Conclusion: The assessment of lesion location at the first stage of multiple sclerosis may be of value to predict future clinical disability.