The changing clinical course of multiple sclerosis: A matter of grey matter

This study from Italy developed a five year longitudinal study looking at demographic, clinical and MRI parameters that could predict the changing clinical course of MS. Clinical and MRI (grey matter and white matter lesions, including spinal cord lesions, global and regional cortical thinning) parameters were assessed in a training set of 334 RRMS patients and in an independent validation set of 84 RRMS patients. Over this time, 19.7% RRMS patients entered into the secondary progressive phase of the disease course. Age, cortical lesion volume and cerebellar cortical volume at study entry were found to predict the changing clinical course. The model, only including these three variables, correctly identified 94% of patients with the RRMS course and 87.8% of patients that became secondary progressive. When this was subsequently applied to the validation set, a similar error rate was seen (8.4%). Grey matter damage appears to play a very important role in determining the clinical course of MS. So in conclusion, this study demonstrates a prediction model based on age, cortical matter damage and cerebellar cortical volume, to explain the probability of RRMS patients to evolve into the progressive phase.

Authors: Calabrese M, Romualdi C, Poretto V,

Source: Ann Neurol. 2013 Mar 12. doi: 10.1002/ana.23882. [Epub ahead of print]

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