Abstract Details

Title "Mild Multiple Sclerosis": Results from an 11 Year Observational Study of Brain Atrophy

Topic MS and Related Diseases

Presentation(s) (-)

Poster/Presentation
Number 002

Objective

Background Benign MS is most commonly defined by disease duration and EDSS. However, disease onset cannot be determined accurately and EDSS is insensitive to arm, visual, and cognitive disability. A more accurate definition of mild MS could accelerate research on factors accounting for disease heterogeneity.

Design/Methods 81 research subjects (64 with MS and 17 HCs) were studied in an observational protocol for a mean of 11.2 years. At least annually, subjects had clinical assessments and standardized brain MRI scans. Whole brain atrophy was determined from BPF slopes over the study period, and patients were classified as mild MS if BPF slope was better than the 25th percentile of HCs. Characteristics predicting mild MS were identified.

Results Among 35 patients who entered with RRMS, 10 (29%) were later defined as mild MS. Baseline factors that distinguished mild from more severe MS were: MSFC (+4.5 vs -0.1, p < 0.01); EDSS (1.6 vs 3.4, p < 0.01); T1 black hole volume (0.74 ml vs 5.3 ml, p < 0.001); T2 volume (10.4 ml vs 31.4 ml, p < 0.001); and BPF (0.85 vs 0.83, p < 0.01). During the study, MSFC change and MSFC progression status, but not EDSS change or EDSS progression status, distinguished the groups. Results of multivariate models for predicting mild MS will be presented.

Conclusions We defined mild MS using the rate of whole brain atrophy over a long observation period. This classification method may be valuable for research into disease heterogeneity in MS. Resulting insights could have major therapeutic implications.

Authors/Disclosures
Richard A. Rudick, MD, FAAN (Optimal Brain Health Consultants) PRESENTER	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.
	No disclosure on file
Elizabeth Fisher, PhD (Dept of Biomedical Engineering/WB3)	No disclosure on file
David A. Wolk, MD, FAAN (University of Pennsylvania)	Dr. Wolk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Wolk has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Functional Neuromodulation. Dr. Wolk has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for GSK. The institution of Dr. Wolk has received research support from Biogen. Dr. Wolk has received publishing royalties from a publication relating to health care. Dr. Wolk has received personal compensation in the range of $5,000-$9,999 for serving as a CME speaker with Eli Lilly.

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