Abstract Details

Title Atrophied T2 lesion volume is Associated with Disability Progression and Conversion to Secondary-Progressive Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) S12 - Progressive Multiple Sclerosis (1:33 PM-1:44 PM)

Poster/Presentation
Number 004

Background Atrophied T2-LV is a novel imaging measure that reflects the disappearance of T2 lesions into cerebrospinal fluid spaces. In recent studies, atrophied T2-LV showed a robust association with development of long-term disability and its accumulation was accelerated in patients with SPMS.

Objective To investigate the associations of cumulative atrophied T2 lesion volume (LV), accumulation of T2-LV, and percent brain volume change (PBVC) with development of disability progression (DP) and conversion to secondary-progressive (SP) multiple sclerosis (MS) in a large cohort of MS patients followed over 5 years.

Design/Methods 1,612 subjects, including 1,341 MS (1,089 with relapsing-remitting MS, RRMS, 217 with SPMS and 35 with primary-progressive MS, PPMS) and 124 clinically isolated syndrome (CIS) patients, and 147 healthy individuals (HI) were followed over 5 years with clinical and MRI examinations. Accumulation of T2-LV, atrophied T2-LV and PBVC were measured and DP was defined using standardized guidelines. Annualized rates were calculated.

Results Over the follow-up, 336 (25.1%) MS patients developed DP, and 60 (4.9%) converted from CIS or RRMS to SPMS. MS patients who developed DP showed higher annualized atrophied T2-LV (p<0.001) and PBVC (p=0.001), but not T2-LV change (p=0.614) compared to non-DP patients. Only annualized atrophied T2-LV (p=0.001) was associated with conversion from CIS or RRMS to SPMS, but this was not observed for PBVC (p=0.120) or T2-LV change (p=0.783). While the annualized PBVC (-0.84% vs -0.89, p=0.434) and T2-LV changes (177.5 vs. 19.1 mm³, p=0.228) were not significantly different between RRMS and SPMS patients over the follow-up, the atrophied T2-LV was significantly higher in SPMS compared to RRMS patients (115.1 vs. 62 mm³, p<0.0001). The lowest annualized atrophied T2-LV was observed in HI (5.44 mm³) and CIS (16.8 mm³), while PPMS patients accumulated 86 mm³.

Conclusions Atrophied T2-LV is a robust MRI biomarker of DP and conversion to SPMS.

Authors/Disclosures
Robert Zivadinov, MD, PhD, FAAN (Buffalo Neuroimaging Analysis Center) PRESENTER	The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Omnicuris. The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Myrobalan. Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Zivadinov has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono. Dr. Zivadinov has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Bristol Myers Squibb. The institution of Dr. Zivadinov has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen.
Jesper Hagemeier	No disclosure on file
Valentina Genovese	No disclosure on file
Niels Bergsland (Buffalo Neuroimaging Analysis Center / State University of New York At Buffalo)	Prof. Bergsland has nothing to disclose.
Dejan Jakimovski, MD, PhD (Buffalo Neuroimaging Analysis Center, University at Buffalo)	Dr. Jakimovski has nothing to disclose.
	No disclosure on file
David Hojnacki, MD, FAAN (University At Buffalo, Jacobs Neurological Institute)	Dr. Hojnacki has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Hojnacki has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Hojnacki has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen.
Channa Kolb, MD	No disclosure on file
Michael G. Dwyer III, MD, PhD (Buffalo Neurological Analysis Center)	Dr. Dwyer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Dwyer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Keystone Heart, Ltd. Dr. Dwyer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Dwyer has received research support from Novartis. The institution of Dr. Dwyer has received research support from Keystone Heart, Ltd. The institution of Dr. Dwyer has received research support from Bristol Myers Squibb. The institution of Dr. Dwyer has received research support from Roche.
Bianca Weinstock-Guttman, MD (Department of Neurology, University At Buffalo)	Dr. Weinstock-Guttman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis . Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme &Sanofi. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen . Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Weinstock-Guttman has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Weinstock-Guttman has received personal compensation in the range of $0-$499 for serving as a Reviewer with NIH.

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