Relapse May Serve as a Mediator Variable in Longitudinal Outcomes in Multiple Sclerosis
| Autor: | Elizabeth Fisher, Henry F. McFarland, Gary Cutter, Lael Stone, C. N. Bash, Jennifer McCartin, Joan Ohayon, Nancy Richert |
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| Rok vydání: | 2015 |
| Předmět: |
Oncology
Pathology medicine.medical_specialty medicine.diagnostic_test business.industry Multiple sclerosis 05 social sciences Magnetic resonance imaging medicine.disease 050105 experimental psychology Hyperintensity Disease activity 03 medical and health sciences 0302 clinical medicine Text mining Internal medicine medicine 0501 psychology and cognitive sciences Radiology Nuclear Medicine and imaging Causal sequence Neurology (clinical) business Mri scan Clinical evaluation 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neuroimaging. 26:296-302 |
| ISSN: | 1051-2284 |
| Popis: | BACKGROUND/PURPOSE Contrast-enhancing lesions (CEL) on magnetic resonance imaging (MRI) are believed to represent inflammatory disease activity in multiple sclerosis (MS), but their relationship to subsequent long-term disability and progression is unclear, particularly at longer time periods such as 8-10 years. METHODS Between 1989 and 1994, 111 MS patients were seen at the National Institutes of Health for clinical evaluations and 3 monthly contrast-enhanced MRI scans. Of these, 94 patients were re-evaluated a mean of 8 years later (range 6.1-10.5 years) with a single MRI scan and clinical evaluation. CEL number and volume were determined at baseline and follow-up. The number of relapses was ascertained over the follow-up period and annualized relapse rates were calculated. Other MRI parameters, such as T2 hyperintensity volume, T1 volume, and brain parenchymal fraction, were also calculated. RESULTS While there was no direct correlation between CEL number or volume at baseline and disability status at follow-up, CEL measures at baseline did correlate with number of relapses observed in the subsequent years, and the number of relapses in turn correlated with subsequent disability as well as transition to progressive MS. CONCLUSION While number and volume of CEL at baseline do not directly correlate with disability in the longer term in MS, our data suggest that 1 route to disability involves relapses as a mediator variable in the causal sequence of MS progression from CEL to disability. Further studies using relapse as a mediator variable in a larger data set may be warranted. |
| Databáze: | OpenAIRE |
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