Dynamic disability measures decrease the clinico-radiological gap in people with severely affected multiple sclerosis.

Clinico-radiological paradox Disability scales EDSS MSSS Multiple sclerosis SNRS Severely disabled ms

Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
22 Apr 2024
Historique:
received: 30 11 2023
revised: 05 04 2024
accepted: 13 04 2024
medline: 29 4 2024
pubmed: 29 4 2024
entrez: 28 4 2024
Statut: aheadofprint

Résumé

Expanded Disability Status Scale (EDSS) is limited when utilized in highly disabled people with multiple sclerosis (pwMS). To explore the relationship between disability measures and MRI outcomes in severely-affected pwMS. PwMS recruited from The Boston Home (TBH), a specialized residential facility for severly-affected pwMS and University at Buffalo (UB) MS Center were assessed using EDSS, MS Severity Scale, age-related MSS, Scripps Neurological Rating Scale (SNRS) and Combinatorial Weight-Adjusted Disability Score (CombiWISE). In all scores except SNRS, higher score indicates greater disability. MRI measures of T1, T2-lesion volume (LV), whole brain, gray matter, medulla oblongata and thalamic volumes (WBV, GMV, MOV, TV) and thalamic dysconnectivity were obtained. Greatest disability differences between the TBH and UB pwMS were in SNRS (24.4 vs 71.9, p < 0.001, Cohen's d = 4.05) and CombiWISE (82.3 vs. 38.9, p < 0.001, Cohen's d = 4.02). In combined analysis of all pwMS, worse SNRS scores were correlated with worse MRI pathology in 8 out of 9 outcomes. EDSS only with 3 measures (GMV, MOV and TV). In severely-affected pwMS, SNRS was associated with T1-LV, T2-LV and WBV (not surviving false discovery rate (FDR) correction for multiple comparisons) whereas EDSS did not. Granular and dynamic disability measures may bridge the clinico-radiologcal gap present in severely affected pwMS.

Sections du résumé

BACKGROUND BACKGROUND
Expanded Disability Status Scale (EDSS) is limited when utilized in highly disabled people with multiple sclerosis (pwMS).
OBJETIVE OBJECTIVE
To explore the relationship between disability measures and MRI outcomes in severely-affected pwMS.
METHODS METHODS
PwMS recruited from The Boston Home (TBH), a specialized residential facility for severly-affected pwMS and University at Buffalo (UB) MS Center were assessed using EDSS, MS Severity Scale, age-related MSS, Scripps Neurological Rating Scale (SNRS) and Combinatorial Weight-Adjusted Disability Score (CombiWISE). In all scores except SNRS, higher score indicates greater disability. MRI measures of T1, T2-lesion volume (LV), whole brain, gray matter, medulla oblongata and thalamic volumes (WBV, GMV, MOV, TV) and thalamic dysconnectivity were obtained.
RESULTS RESULTS
Greatest disability differences between the TBH and UB pwMS were in SNRS (24.4 vs 71.9, p < 0.001, Cohen's d = 4.05) and CombiWISE (82.3 vs. 38.9, p < 0.001, Cohen's d = 4.02). In combined analysis of all pwMS, worse SNRS scores were correlated with worse MRI pathology in 8 out of 9 outcomes. EDSS only with 3 measures (GMV, MOV and TV). In severely-affected pwMS, SNRS was associated with T1-LV, T2-LV and WBV (not surviving false discovery rate (FDR) correction for multiple comparisons) whereas EDSS did not.
CONCLUSION CONCLUSIONS
Granular and dynamic disability measures may bridge the clinico-radiologcal gap present in severely affected pwMS.

Identifiants

DOI: 10.1016/j.msard.2024.105630 PMID: 38678969
pubmed: 38678969
pii: S2211-0348(24)00207-4
doi: 10.1016/j.msard.2024.105630
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105630

Informations de copyright

Copyright © 2024 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest Dejan Jakimovski, Zachary Weinstock, Taylor Wicks, Christopher Suchan, Tommaso Sciortino, Niels Bergsland, Ferdinand Schweser, Cheryl Kennedy have nothing to disclose. Alex Burnham, Mark Ostrem, Jessica Reilly and David Young-Hong are employees of the Boston Home. Murali Ramanathan received research funding from the Department of Defense, National Science Foundation, and the National Institutes of Health. Michael G. Dwyer has received personal compensation from Mapi Pharma for consultant fees. He received financial support for research activities from Bristol Myers Squibb, Mapi Pharma, Protembis and V-WAVE Medical. Svetlana Eckert received consultant fees from Genentech. David Hojnacki received speaking and consulting from Biogen Idec and Bristol Myers Squibb. Ralph HB. Benedict has received consultation or speaking fees from Bristol Myer Squibb, Biogen, Merck, EMD Serono, Roche, Verasci, Immune Therapeutics, Novartis, and Sanofi-Genzyme. Bianca Weinstock-Guttman has received grant/research support Novartis, Genentech, EMD Serono, Celgene/Bristol Meyers Squibb, Sanofi &Genzyme, Janssen, Horizon, Bayer, Labcorp and has participated in speaker's bureaus for Biogen. She serves in the editorial board for BMJ Neurology, Children, CNS Drugs, MS International, Journal of Neurology and Frontiers Epidemiology. Robert Zivadinov has received personal compensation from Bristol Myers Squibb, EMD Serono, Sanofi, Janssen, Sanofi, 415 Capital, Filterlex and Mapi Pharma for speaking and consultant fees. He received financial support for research activities from Novartis, Bristol Myers Squibb, EMD Serono, Octave, Mapi Pharma, CorEvitas, Protembis and V-WAVE Medical.

Auteurs

Dejan Jakimovski (D)

Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.

Bianca Weinstock-Guttman (B)

Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.

Alex Burnham (A)

The Boston Home, Dorchester, MA, USA.

Zachary Weinstock (Z)

Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.

Taylor R Wicks (TR)

Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.

Murali Ramanathan (M)

Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.

Tommaso Sciortino (T)

Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.

Mark Ostrem (M)

The Boston Home, Dorchester, MA, USA.

Christopher Suchan (C)

Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.

Michael G Dwyer (MG)

Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA.

Jessica Reilly (J)

The Boston Home, Dorchester, MA, USA; Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA.

Niels Bergsland (N)

Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.

Ferdinand Schweser (F)

Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA.

Cheryl Kennedy (C)

Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.

David Young-Hong (D)

The Boston Home, Dorchester, MA, USA.

Svetlana P Eckert (SP)

Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.

David Hojnacki (D)

Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.

Ralph Hb Benedict (RH)

Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.

Robert Zivadinov (R)

Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA.

Classifications MeSH