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Relationship between brain atrophy and disability: an 8-year follow-up study of multiple sclerosis patients
E Fisher
Department of Biomedical Engineering, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA
R A Rudick
Department of Neurology (Mellen Center), The Cleveland Clinic Foundation, Cleveland, OH 44195, USA
G Cutter
Center for Research Methodology and Biometrics, AMC Cancer Research Center, Lakewood, CO 80214, USA
M Baier
Center for Research Methodology and Biometrics, AMC Cancer Research Center, Lakewood, CO 80214, USA
D Miller
Department of Neurology (Mellen Center), The Cleveland Clinic Foundation, Cleveland, OH 44195, USA
B Weinstock-Guttman
Department of Neurology, Buffalo General Hospital, Buffalo, NY 14203, USA
M K Mass
Department of Neurology, Oregon Health Sciences University, Portland, OR 97201, USA
D S Dougherty
DVHIP, Walter Reed Army Medical Center, Washington, DC 20307, USA
N A Simonian
Biogen, Inc. Boston, MA 02142, USA
Brain atrophy measurement can provide an estimate of the amount of tissue destruction due to the pathologic processes in multiple sclerosis. The potential usefulness of atrophy as a marker of disease progression depends upon the concurrent and predictive relationships between atrophy and disability. A follow-up study was performed to measure atrophy and disability scores in patients from the Multiple Sclerosis Collaborative Research Group's phase III trial of IFNb-1a (Avonex) in relapsing-remitting multiple sclerosis. New data were obtained on 160 out of 172 eligible patients from the original trial were enrolled in the follow-up study approximately 8 years after randomization. The follow-up visit consisted of several tests and questionnaires including a clinical exam to determine Expanded Disability Status Score (EDSS) and Multiple Sclerosis Functional Composite (MSFC), and a magnetic resonance imaging exam to calculate the brain parenchymal fraction. Brain parenchymal fraction was correlated with both EDSS and MSFC at each of the four time points for which data were available (baseline 1, 2 and 8 years). Furthermore, the change in BPF was correlated with the changes in disability scores from the end of the phase III trial to the follow-up exam. These data suggest that brain atrophy may be a useful and clinically relevant marker of disease progression in relapsing-remitting MS.
Key Words: multiple sclerosis • magnetic resonance imaging • brain atrophy
Multiple Sclerosis, Vol. 6, No. 6,
373-377 (2000)
DOI: 10.1177/135245850000600602
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