Whole brain volume loss is associated with a short-term disability progression in relapse-activity free multiple sclerosis.

IF 4.6 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Neurology Pub Date : 2025-10-21 DOI:10.1007/s00415-025-13343-2

Roland Opfer, Lothar Spies, Julia Krüger, Thomas Buddenkotte, Holger Roick, Manda Jankovic, Nicolaj Witt, Sylke Domke, Ralf Kubalek, Gerd Reifschneider, Jürgen Kunz, Ilias Nastos, Felicita Heidler, George Trendelenburg, Andreas Stockert, Deborah K Erhart, Hayrettin Tumani, Hagen H Kitzler, Tjalf Ziemssen

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引用次数: 0

Abstract

Background: Reliable biomarkers for disability progression independent of relapse activity (PIRA) in multiple sclerosis (MS) applicable in routine patient care are urgently needed. This study reports results from an ongoing multicenter, prospective, observational study with the primary objective of investigating the association of change in brain MRI biomarkers and PIRA.

Methods: In total 453 active relapsing remitting patients from 19 sites with baseline (BL) and one-year follow-up (FU) visits were included. At each visit, medication, relapse activity, and EDSS were recorded. MRI included 3D-T1 and 2D/3D-FLAIR. BL and FU scans enabled extraction of new/enlarged T2-lesions and brain volume loss (BVL) (annualized). Correlations and logistic regression assessed associations between EDSS progression and BVL/year.

Results: At BL an EDSS (25%/50%/75%) of 1.5/2.0/2.5 and a time since first MS diagnosis of 2.1/5.7/11.4 years were observed. Change (FU-BL): ΔEDSS was 0.0/0.0/0.0, BVL/year was $-$ 0.5/ $-$ 0.3/ $-$ 0.0%, age-adjusted BVL/year was $-$ 0.4/ $-$ 0.1/0.2%, and number of new/enlarged T2-lesions per year was 0.0/0.0/0.6. 75% of patients were relapse activity-free during the observation period, 72% had no new/enlarged T2-lesions, and 56% were free of both. BVL/year (adjusted for age) correlated with ΔEDSS (r = $-$ 0.14, p = 0.002) for all patients, but also for sub-cohorts of patients without new/enlarged T2-lesions and without relapses (r = $-$ 0.17, p = 0.008). BVL/year was significantly associated with EDSS progression in the logistic regression model (p < 0.001). The risk of EDSS progression increases from 15% to 19% (relative risk increase of 26%), when BVL/year declines from $-$ 0.5% to $-$ 1.0%.

Conclusions: BVL over one year was significantly associated with EDSS progression in the absence of relapses or new lesions, confirming its value as a short-term risk marker for disability progression in MS.

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全脑容量损失与无复发活动多发性硬化症的短期残疾进展有关。

背景：目前迫切需要可靠的、独立于复发活动（PIRA）的生物标志物，用于多发性硬化症（MS）患者的常规护理。本研究报告了一项正在进行的多中心、前瞻性、观察性研究的结果，其主要目的是调查脑MRI生物标志物变化与PIRA的关系。方法：共有453名来自19个地点的活跃复发缓解患者，基线（BL）和一年随访（FU）访问。每次就诊时，记录用药、复发活动和EDSS。MRI包括3D-T1和2D/3D-FLAIR。BL和FU扫描能够提取新的/扩大的t2病变和脑容量损失（BVL）（年化）。相关性和逻辑回归评估了EDSS进展与BVL/年之间的关系。结果：在BL中，EDSS（25%/50%/75%）为1.5/2.0/2.5，自首次诊断为MS的时间为2.1/5.7/11.4年。变化（FU-BL）： ΔEDSS为0.0/0.0/0.0，BVL/年为- 0.5/ - 0.3/ - 0.0%，年龄调整BVL/年为- 0.4/ - 0.1/0.2%，每年新发/扩大的t2病变数为0.0/0.0/0.6。75%的患者在观察期内无复发活动，72%的患者无新的/扩大的t2病变，56%的患者两者均无。BVL/年（经年龄调整）与所有患者ΔEDSS相关（r = - 0.14, p = 0.002），但也适用于无新发/扩大t2病变和无复发的患者亚队列（r = - 0.17, p = 0.008）。在logistic回归模型中，BVL/年与EDSS进展显著相关（p - 0.5%至- 1.0%）。结论：在没有复发或新病变的情况下，BVL超过一年与EDSS进展显著相关，证实了其作为MS残疾进展的短期风险标志物的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurology 医学-临床神经学

CiteScore

10.00

自引率

5.00%

发文量

558

审稿时长

1 months

期刊介绍： The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.