Journal
MULTIPLE SCLEROSIS JOURNAL
Volume 25, Issue 4, Pages 541-553Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/1352458517742739
Keywords
Multiple sclerosis; MRI; brain atrophy; cut-off value; disability
Categories
Funding
- Biogen Idec
- Czech Ministries of Education and Health [GA CR 16-03322S, PRVOUK-P26/LF1/4, RVO-VFN64165]
- Czech Ministry of Education project Progres Q27/LF1
- University of Economics-Prague -Internal Grant Agency [44/2017]
- Novartis
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Background: Volumetric MRI surrogate markers of disease progression are lacking. Objective: To establish cut-off values of brain volume loss able to discriminate between healthy controls and MS patients. Methods: In total, 386 patients after first demyelinating event suggestive of MS (CIS), 964 relapsing-remitting MS (RRMS) patients, 63 secondary-progressive MS (SPMS) patients and 58 healthy controls were included in this longitudinal study. A total of 11,438 MRI scans performed on the same MRI scanner with the same protocol were analysed. Annualised percentage changes of whole brain, grey matter, thalamus and corpus callosum volumes were estimated. We investigated cut-offs able to discriminate between healthy controls and MS patients. Results: At a predefined specificity of 90%, the annualised percentage change cut-off of corpus callosum volume (-0.57%) was able to distinguish between healthy controls and patients with the highest sensitivity (51% in CIS, 48% in RRMS and 42% in SPMS patients). Lower sensitivities (22%-49%) were found for cut-offs of whole brain, grey matter and thalamic volume loss. Among CIS and RRMS patients, cut-offs were associated with greater accumulation of disability. Conclusion: We identified cut-offs of annualised global and regional brain volume loss rates able to discriminate between healthy controls and MS patients.
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