White matter lesion location correlates with disability in relapsing multiple sclerosis.
- Gaetano L Medical Image Analysis Center, Switzerland.
- Magnusson B Novartis Pharma, Switzerland.
- Kindalova P Department of Statistics, University of Oxford, UK.
- Tomic D Novartis Pharma, Switzerland.
- Silva D Medical Image Analysis Center, Switzerland.
- Altermatt A Medical Image Analysis Center, Switzerland.
- Magon S Medical Image Analysis Center, Switzerland.
- Müller-Lenke N Biomedical Research and Training, Biomedical Research, Switzerland.
- Radue EW Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research, Biomedicine and Biomedical Engineering, University Hospital and University of Basel, Switzerland.
- Leppert D Medical Image Analysis Center, Switzerland.
- Kappos L Novartis Pharma, Switzerland.
- Wuerfel J Medical Image Analysis Center, Switzerland.
- Häring DA
- Sprenger T
- 2020-03-05
Published in:
- Multiple sclerosis journal - experimental, translational and clinical. - 2020
White matter lesion
demyelination
disability
fingolimod
frontal lobe
multiple sclerosis and neuroinflammation
multiple sclerosis: imaging
English
Background
Lesion location is a prognostic factor of disease progression and disability accrual.
Objective
To investigate lesion formation in 11 brain regions, assess correlation between lesion location and physical and cognitive disability measures and investigate treatment effects by region.
Methods
In 2355 relapsing-remitting multiple sclerosis patients from the FREEDOMS and FREEDOMS II studies, we extracted T2-weighted lesion number, volume and density for each brain region; we investigated the (Spearman) correlation in lesion formation between brain regions, studied association between location and disability (at baseline and change over 2 years) using linear/logistic regression and assessed the regional effects of fingolimod versus placebo in negative binomial models.
Results
At baseline, the majority of lesions were found in the supratentorial brain. New and enlarging lesions over 24 months developed mainly in the frontal and sublobar regions and were substantially correlated to pre-existing lesions at baseline in the supratentorial brain (p = 0.37-0.52), less so infratentorially (p = -0.04-0.23). High sublobar lesion density was consistently and significantly associated with most disability measures at baseline and worsening of physical disability over 24 months. The treatment effect of fingolimod 0.5 mg was consistent across the investigated areas and tracts.
Conclusion
These results highlight the role of sublobar lesions for the accrual of disability in relapsing-remitting multiple sclerosis.
Lesion location is a prognostic factor of disease progression and disability accrual.
Objective
To investigate lesion formation in 11 brain regions, assess correlation between lesion location and physical and cognitive disability measures and investigate treatment effects by region.
Methods
In 2355 relapsing-remitting multiple sclerosis patients from the FREEDOMS and FREEDOMS II studies, we extracted T2-weighted lesion number, volume and density for each brain region; we investigated the (Spearman) correlation in lesion formation between brain regions, studied association between location and disability (at baseline and change over 2 years) using linear/logistic regression and assessed the regional effects of fingolimod versus placebo in negative binomial models.
Results
At baseline, the majority of lesions were found in the supratentorial brain. New and enlarging lesions over 24 months developed mainly in the frontal and sublobar regions and were substantially correlated to pre-existing lesions at baseline in the supratentorial brain (p = 0.37-0.52), less so infratentorially (p = -0.04-0.23). High sublobar lesion density was consistently and significantly associated with most disability measures at baseline and worsening of physical disability over 24 months. The treatment effect of fingolimod 0.5 mg was consistent across the investigated areas and tracts.
Conclusion
These results highlight the role of sublobar lesions for the accrual of disability in relapsing-remitting multiple sclerosis.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1177/2055217320906844
- PMID 32128236
- Persistent URL
- https://sonar.ch/global/documents/231818
Statistics
Document views: 29
File downloads:
- Full-text: 0