Abstract Details

Title Structural and Functional Damage of the Sensorimotor Network Contribute to Predict Disability Progression and Phenotype Evolution in Patients with Multiple Sclerosis: A 6.5-Year Follow-Up Study

Topic Multiple Sclerosis

Presentation(s) S49 - MS Epidemiology and Risk Stratification (1:33 PM-1:44 PM)

Poster/Presentation
Number 004

Objective To assess the value of structural and functional network MRI measures in predicting clinical deterioration over a 6.5-year follow-up in patients with multiple sclerosis (MS).

Background In patients with definite MS, no reliable markers to predict medium- and long-term disease evolution are currently available. The analysis of brain structural and functional network architecture might improve the prediction of long-term MS prognosis.

Design/Methods Conventional, 3D T1-weighted, diffusion-weighted MRI and resting state (RS) fMRI scans were obtained at baseline from 233 MS patients and 77 healthy controls. Patients underwent a neurologic evaluation at baseline and after a median follow-up of 6.5 years. At follow-up, patients were classified as clinically stable or worsened according to Expanded Disability Status Scale (EDSS) score change. In relapsing-remitting (RR) MS, conversion to secondary progressive (SP) MS was also evaluated. Spatial independent component analysis was applied to RS fMRI data to derive the main large-scale RS functional connectivity (FC) networks and to grey matter (GM) probability maps and fractional anisotropy maps, to identify the corresponding structural GM and white matter networks.

Results At follow-up, 105/233 (45%) MS patients showed significant EDSS worsening and 26/157 (16%) RRMS patients evolved to SPMS. The multivariable model, adjusted for follow-up duration, identified baseline EDSS (odds ratio [OR]=1.59, p<0.001), normalized GM volume (OR=0.99, p=0.001) and abnormally high baseline RS FC of the left precentral gyrus in the sensorimotor network (OR=1.67, p=0.03) as predictors of EDSS worsening (C-index=0.80). Such variables survived also when adjusting for treatment effect. Baseline EDSS (OR=2.8, p<0.001) and atrophy of GM networks associated with sensory (OR=0.5, p=0.01) and motor (OR=0.4, p=0.03) functions were independent variables associated with conversion to SPMS (C-index=0.89).

Conclusions Structural and functional network measures improved the prediction of long-term clinical worsening in MS patients.

Authors/Disclosures
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit) PRESENTER	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Alessandro Meani	No disclosure on file
	No disclosure on file
Paola Valsasina	No disclosure on file
Claudio Cordani	Claudio Cordani has nothing to disclose.
Elisabetta Pagani	Elisabetta Pagani has nothing to disclose.
Paolo Preziosa (Ospedale San Raffaele)	Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb . Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.
Maria A. Rocca (Neuroimaging Research Unit)	Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.

��ɫ��

��ɫ��