BACKGROUND AND PURPOSE: MRI markers of neuronal and axonal damage in MS have emerged as critical long-term predictors of MS-related disability. Here the researchers investigated the potential of whole-brain diffusivity (
" a big term for a marker of structural integrity of the brain") and brain volume (
"a gross marker of nerve cell bulk") for the prediction of disability and short- to medium-term clinical evolution.
MATERIALS AND METHODS: 54 patients with MS (87% under immunomodulatory therapy, baseline and follow-up at a median of 12 months).
RESULTS: At both time points, ADC (diffusivity) histogram analysis provided robust predictors of the MS functional composite scores (R-squared = 0.58, P < .001)*, incorporated cognition and fine-motor skill subscores, and EDSS scores.
* "R-squared of 0.58 means that 58% of the change of the MSFC can be explained by the changes in the ADC histogram; this is a very impressive correlation. As a doubting Thomas I would need to see this study reproduced."
CONCLUSIONS: Diffusion histogram analysis provided stable surrogates of disability in MS and proved sensitive for monitoring disease progression during a median of 12 months. Advanced neuroaxonal pathology at baseline was indicative of an increased risk for sustained progression during a median of 12 months, independent of intercurrent relapses.