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De Stefano, N; Giorgio, A; Battaglini, M; Rovaris, M; Sormani, MP; Barkhof, F; Korteweg, T; Enzinger, C; Fazekas, F; Calabrese, M; Dinacci, D; Tedeschi, G; Gass, A; Montalban, X; Rovira, A; Thompson, A; Comi, G; Miller, DH; Filippi, M.
Assessing brain atrophy rates in a large population of untreated multiple sclerosis subtypes.
Neurology. 2010; 74(23): 1868-1876.
Doi: 10.1212/WNL.0b013e3181e24136
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- Co-authors Med Uni Graz
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Enzinger Christian
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Fazekas Franz
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- Abstract:
- Objective: To assess the time course of brain atrophy and the difference across clinical subtypes in multiple sclerosis (MS). Methods: The percent brain volume change (PBVC) was computed on existing longitudinal (2 time points) T1-weighted MRI from untreated (trial and nontrial) patients with MS. Patients (n = 963) were classified as clinically isolated syndromes suggestive of MS (CIS, 16%), relapsing-remitting (RR, 60%), secondary progressive (SP, 15%), and primary progressive (9%) MS. The median length of follow-up was 14 months (range 12-68). Results: There was marked heterogeneity of the annualized PBVC (PBVC/y) across MS subtypes (p = 0.003), with higher PBVC/y in SP than in CIS (p = 0.003). However, this heterogeneity disappeared when data were corrected for the baseline normalized brain volume. When the MS population was divided into trial and nontrial subjects, the heterogeneity of PBVC/y across MS subtypes was present only in the second group, due to the higher PBVC/y values found in trial data in CIS (p = 0.01) and RR (p < 0.001). The estimation of the sample sizes required for demonstrating a reduction of brain atrophy in patients in a placebo-controlled trial showed that this was larger in patients with early MS than in those with the progressive forms of the disease. Conclusions: This first large study in untreated patients with multiple sclerosis (MS) with different disease subtypes shows that brain atrophy proceeds relentlessly throughout the course of MS, with a rate that seems largely independent of the MS subtype, when adjusting for baseline brain volume. Neurology (R) 2010; 74: 1868-1876
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Analysis of Variance -
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