The progression of disability in patients with multiple sclerosis was associated with whole brain, cortical, and putamen atrophy during the first 5 years after diagnosis, driven chiefly by a greater decline in gray matter than in white matter volume, according to a report published online in Journal of Neurology, Neurosurgery & Psychiatry.
To identify markers of disability progression in MS, researchers assessed 81 patients residing in Southwestern Norway who were diagnosed in 1998 or 2000 and underwent full neurologic assessments and brain MRI at that time, as well as 5 and 10 years later. Patients whose disability progressed, based on the Expanded Disability Status Scale, during follow-up were no different from those whose disability remained stable in demographic factors, MS subtype, or the use or duration of disease-modifying treatment, said Dr. Cecilie Jacobsen of the department of neurology at Stavanger (Norway) University Hospital and the Neuroimaging Analysis Center at the State University of New York at Buffalo, and her associates.
At 5 years, disease progression was associated with significantly greater volume declines in patients with disease than in those without in measurements of the whole brain (–3.8% vs. –2.0%), cortex (–3.4% vs. –1.8%), and putamen (–10.6% vs. –3.8%). However, at 10 years, there was only a nonsignificant trend toward decreased whole brain volume among patients with disease progression. The correlation was much stronger between disability progression and the decline in gray matter volume than it was between disability progression and the decline in white matter volume. "These findings strengthen the increasing evidence that [gray matter] pathology may be playing a crucial role in MS-related disability progression," the investigators wrote (J. Neurol. Neurosurg. Psychiatry 2014 Feb. 19 [doi:10.1136/jnnp-2013-306906]).
They cautioned that their study was limited by its relatively small sample size and by its "considerable" dropout rate (38%) through 10 years.
Dr. Jacobsen’s associates reported ties to numerous industry sources.