好色先生

好色先生

Explore the latest content from across our publications

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Survival prediction models in motor neuron disease
Neuromuscular and Clinical Neurophysiology (EMG)
P6 - Poster Session 6 (11:30 AM-1:00 PM)
15-018

MND is a fatal neurodegenerative condition showing a highly heterogenous clinical progression. Neuroimaging provides reliable quantitative measures of upper motor neuron damage and extra-motor involvement, with important prognostic implications.

To assess the predictive value of multimodal brain magnetic resonance imaging (MRI) on survival in a large cohort of patients with motor neuron disease (MND), in combination with clinical and cognitive features.

Two hundred patients with MND were followed-up for a median time of 4.13 years. At baseline, subjects underwent neurologic examination, cognitive assessment, and brain MRI. Grey matter (GM) volumes of cortical and subcortical structures and diffusion tensor (DT) MRI metrics of white matter (WM) tracts were obtained. A multivariable Royston-Parmar survival model was created using clinical and cognitive variables. The increase of survival prediction accuracy provided by the inclusion of MRI variables was assessed.

The multivariable clinical model included predominant upper (PUMN) or lower motor neuron (PLMN) presentations and diagnostic delay as significant prognostic predictors, reaching an area under the ROC curve (AUC) of survival prediction at 4 years of 0.79. The combined clinical and MRI model including GM volumes of selected fronto-temporal regions and DT MRI metrics of the corticospinal and extra-motor tracts reached an AUC of 0.89. Considering amyotrophic lateral sclerosis (ALS) patients only, the multivariable clinical model including diagnostic delay and semantic fluency scores provided an AUC of 0.62, whereas the combined clinical and MRI model reached an AUC of 0.77.

Our study demonstrated that brain MRI measures of structural damage of the motor and extra-motor systems, when combined with clinical and cognitive features, are useful predictors of survival in patients with MND, particularly when a diagnosis of ALS is made.

Authors/Disclosures
Edoardo G. Spinelli, MD
PRESENTER
Dr. Spinelli has nothing to disclose.
Federica Agosta (San Raffaele Scientific Institute) Federica Agosta has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Philips. Federica Agosta has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier INC.
No disclosure on file
No disclosure on file
Silvia Basaia Silvia Basaia has nothing to disclose.
Elisa Canu (Ospedale San Raffaele) The institution of Elisa Canu has received research support from Italian Ministry of Health .
Veronica Castelnovo, MSc (San Raffaele Scientific Institute, Vita-Salute San Raffaele University) Dr. Castelnovo has nothing to disclose.
Yuri Falzone Yuri Falzone has nothing to disclose.
No disclosure on file
No disclosure on file
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit) Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.