Abstract Details

Title Temporal Patterns of Brain Atrophy in Individual Multiple Sclerosis Patients

Topic MS and Related Diseases

Presentation(s) S51 - (-)

Poster/Presentation
Number 001

Objective

Background Previous studies comparing atrophy rates across MS patient subgroups report conflicting results and have not addressed changes in individuals. Consequently, it remains uncertain whether atrophy rate remains constant or changes over time.

Design/Methods MS patients and age-matched HCs were entered into an observational study. Brain MRI scans and disability scores were assessed at least yearly. Normalized whole brain volume (BPF) was calculated at each timepoint. T2 lesions, T1 hypointensities, contrast enhancing lesions, and whole brain magnetization transfer ratio were quantified at baseline. For each subject, bootstrap analysis was used to determine the best-fit equation for the BPF data to classify atrophy as constant (linear), accelerating (quadratic fit curving downward), or decelerating (quadratic fit curving upward).

Results Sixty-four MS patients and 17 healthy control subjects were followed for a mean of 11.2±1.2 years (range: 7-12 years). For the MS patients, 26(41%) had accelerating atrophy, 24(38%) had a constant rate of atrophy, and 14(22%) had decelerating atrophy. In contrast, 9(53%) controls had a constant rate, 5(29%) had decelerating atrophy, and only 3(18%) had accelerating atrophy. The atrophy pattern patient groups did not differ by age, disease duration, disease category, disability progression (based on MSFC or EDSS), or atrophy slope. There was a highly significant difference in gender distribution (92% of the accelerating group were female, p=0.0006). The accelerating group also had lower baseline EDSS (p=0.025), less change in MSFC (p= 0.018) and trends toward higher baseline BPF, lower T1LV, lower T2LV, and higher WB MTR.

Conclusions Accelerating atrophy was the most common pattern among MS patients, but the patterns varied widely between individuals. Lack of association with disease duration and disease category suggest that atrophy patterns may reflect different underlying mechanisms not distinguishable by conventional disease measures.

Authors/Disclosures
Elizabeth Fisher, PhD (Dept of Biomedical Engineering/WB3) PRESENTER	No disclosure on file
	No disclosure on file
Richard A. Rudick, MD, FAAN (Optimal Brain Health Consultants)	Dr. Rudick has received personal compensation for serving as an employee of Biogen. Dr. Rudick has received stock or an ownership interest from Biogen. Dr. Rudick has received publishing royalties from a publication relating to health care.
Douglas L. Arnold, MD, FAAN (Montreal Neurological Institute, McGill Univ)	Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BMS. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Frequency Therapeutics. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Xfacto communications. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Find therapeutics. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GSK. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Idorsia. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kiniksa. Dr. Arnold has stock in NeuroRx.

��ɫ��

��ɫ��