Brain atrophy and lesion burden are associated with disability progression in a multiple sclerosis real-world dataset using only T2-FLAIR: The NeuroSTREAM MSBase study,NeuroImage: Clinical

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Brain atrophy and lesion burden are associated with disability progression in a multiple sclerosis real-world dataset using only T2-FLAIR: The NeuroSTREAM MSBase study
NeuroImage: Clinical ( IF 4.2 ) Pub Date : 2021-08-24 , DOI: 10.1016/j.nicl.2021.102802
Michael Barnett ₁ , Niels Bergsland ₂ , Bianca Weinstock-Guttman ₃ , Helmut Butzkueven ₄ , Tomas Kalincik ₅ , Patricia Desmond ₆ , Frank Gaillard ₆ , Vincent van Pesch ₇ , Serkan Ozakbas ₈ , Juan Ignacio Rojas ₉ , Cavit Boz ₁₀ , Ayse Altintas ₁₁ , Chenyu Wang ₁ , Michael G Dwyer ₁₂ , Suzie Yang ₁₃ , Dejan Jakimovski ₁₄ , Kain Kyle ₁ , Deepa P Ramasamy ₁₄ , Robert Zivadinov ₁₂

Affiliation

Sydney Neuroimaging Analysis Centre, Camperdown, Sydney, Australia; Brain and Mind Centre, University of Sydney, Sydney, Australia.
Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, NY, USA; IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Italy.
Jacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, NY, USA.
Box Hill Hospital, Melbourne, Australia.
CORe, Department of Medicine, The University of Melbourne, Melbourne, Australia; MS Centre, The Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia.
Department of Radiology, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia.
Cliniques Universitaires Saint-Luc, Brussels, UCLouvain, Belgium.
Dokuz Eylül University, Izmir, Turkey.
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
KTU Medical Faculty Farabi Hospital, Trabzon, Turkey.
Koç University School of Medicine, Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Turkey.
Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, NY, USA; Center for Biomedical Imaging, Clinical Translational Science Institute, USA; University at Buffalo, NY, USA.
Sydney Neuroimaging Analysis Centre, Camperdown, Sydney, Australia.
Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, NY, USA.

Background

Methodological challenges limit the use of brain atrophy and lesion burden measures in the follow-up of multiple sclerosis (MS) patients on clinical routine datasets.

Objective

To determine the feasibility of T2-FLAIR-only measures of lateral ventricular volume (LVV) and salient central lesion volume (SCLV), as markers of disability progression (DP) in MS.

Methods

A total of 3,228 MS patients from 9 MSBase centers in 5 countries were enrolled. Of those, 2,875 (218 with clinically isolated syndrome, 2,231 with relapsing-remitting and 426 with progressive disease subtype) fulfilled inclusion and exclusion criteria. Patients were scanned on either 1.5 T or 3 T MRI scanners, and 5,750 brain scans were collected at index and on average after 42.3 months at post-index. Demographic and clinical data were collected from the MSBase registry. LVV and SCLV were measured on clinical routine T2-FLAIR images.

Results

Longitudinal LVV and SCLV analyses were successful in 96% of the scans. 57% of patients had scanner-related changes over the follow-up. After correcting for age, sex, disease duration, disability, disease-modifying therapy and LVV at index, and follow-up time, MS patients with DP (n = 671) had significantly greater absolute LVV change compared to stable (n = 1,501) or disability improved (DI, n = 248) MS patients (2.0 mL vs. 1.4 mL vs. 1.1 mL, respectively, ANCOVA p < 0.001, post-hoc pair-wise DP vs. Stable p = 0.003; and DP vs. DI, p = 0.002). Similar ANCOVA model was also significant for SCLV (p = 0.03).

Conclusions

LVV-based atrophy and SCLV-based lesion outcomes are feasible on clinically acquired T2-FLAIR scans in a multicenter fashion and are associated with DP over mid-term.

中文翻译：

在仅使用 T2-FLAIR 的多发性硬化症真实世界数据集中，脑萎缩和病变负担与残疾进展相关：NeuroSTREAM MSBase 研究

背景

方法学上的挑战限制了在临床常规数据集上对多发性硬化症 (MS) 患者进行随访时使用脑萎缩和病变负荷措施。

客观的

确定仅 T2-FLAIR 测量侧脑室容积 (LVV) 和突出中央病变容积 (SCLV) 作为 MS 残疾进展 (DP) 标志物的可行性。

方法

共有来自 5 个国家/地区的 9 个 MSBase 中心的 3,228 名 MS 患者入组。其中，2,875 人（218 人患有临床孤立综合征，2,231 人患有复发缓解型，426 人患有进行性疾病亚型）符合纳入和排除标准。患者在 1.5 T 或 3 T MRI 扫描仪上进行扫描，并在索引时收集了 5,750 次脑部扫描，索引后平均在 42.3 个月后收集。人口统计学和临床数据是从 MSBase 登记处收集的。在临床常规 T2-FLAIR 图像上测量 LVV 和 SCLV。

结果

纵向 LVV 和 SCLV 分析在 96% 的扫描中是成功的。57% 的患者在随访期间出现了与扫描仪相关的变化。在针对年龄、性别、病程、残疾、疾病改善治疗和指数时的 LVV 以及随访时间进行校正后，患有 DP 的 MS 患者 (n = 671) 与稳定患者 (n = 1,501) 相比，绝对 LVV 变化明显更大或残疾改善（DI，n = 248）MS 患者（分别为 2.0 mL vs. 1.4 mL vs. 1.1 mL，ANCOVA p < 0.001，事后成对 DP 与稳定 p = 0.003；DP 与 DI , p = 0.002)。类似的 ANCOVA 模型对 SCLV 也很重要 (p = 0.03)。