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• W2190578328 abstract "Introduction: The clinical severity of MS is heterogeneous and is currently difficult to predict. To better understand what drives this heterogeneity, identification of MRI-phenotypes that combine the two key pathological features of MS (inflammation and degeneration) might be a useful method for patient stratification. This study looked at whether stratification into such phenotypes is clinically informative across a large, well-defined cohort of patients, as well as a sub-cohort of patients with short disease duration. Methods: 429 patients were stratified into phenotype-groups based on accepted MRI-measurements of inflammation (T2 lesion load (T2LL); “I”) and degeneration (normalized gray matter volume (NGMV); “D”). Based on a median split of logarithmic transformed T2LL data and NGMV data, four groups were created; 1) Ilow-Dlow, 2) Ihigh-Dlow, 3) Ilow-Dhigh, 4) Ihigh-Dhigh. All analyses were performed in the total cohort (N=429) as well as in a subcohort of patients with ”short” ( = 10 years, N=219) disease duration. Subsequently, associations between the 4 phenotype-groups and clinical measures (Expanded Disability Status Scale (EDSS) scores, 9-Hole Peg Test (9-HPT) and Timed 25-foot Walk Test (25F-TWT)) were analysed in all three cohorts separately using a linear regression method with correction for disease duration and gender. Results: In the total cohort, patients in group Ihigh-Dhigh performed significantly worse compared to group Ilow-Dlow on the EDSS score (median 4 vs 2.5; p>10^-5), the 9-HPT (31.6 vs 18.9 sec; p>10^-5), and the 25F-TWT (18.6 vs 7.0 sec; p>0.001). A similar effect was present for group Ilow-Dhigh compared to group Ilow-Dlow and group Ihigh-Dhigh compared to group Ihigh-Dlow. In the short cohort, group Ihigh-Dhigh also performed significantly worse on all clinical measures compared to groups Ilow-Dlow and Ihigh-Dlow. Within the long cohort the differences were less prominent. Here, group Ihigh-Dhigh performed only significantly worse on the 9-HPT compared to group Ilow-Dlow. Discussion: Stratification based on MRI features creates clinically informative phenotype-groups. Patients with higher inflammation and degeneration perform significantly worse on clinical measures of disability, even after short disease duration. Interestingly, patients that are stratified into a profile with higher degeneration perform clinically Phenotyping MS an imaging study | 25" @default.
• W2190578328 created "2016-06-24" @default.
• W2190578328 creator A5023972995 @default.
• W2190578328 date "2014-06-06" @default.
• W2190578328 modified "2023-09-28" @default.
• W2190578328 title "Towards endophenotyping multiple sclerosis" @default.
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• W2190578328 hasPublicationYear "2014" @default.
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