• 作者：Juan Ignacio Rojas^a ; ^{juan.rojas@hospitalitaliano.org.ar} ; Liliana Patrucco^a ; Cristina Besada^b ; Jorge Funes^b ; Laura Bengolea^b ; Edgardo Cristiano^a
• 关键词：Atrofia cerebral ; Structural Image Evaluation using ; Normalisation of Atrophy (SIENA) ; Esclerosis mú ; ltiple Discapacidad
• 刊名：Neurolog铆a Argentina
• 出版年：2011
• 期刊代码：pca377_18530028
• 类别：neu
• 出版时间：April-June 2011
• 卷：3
• 期：2
• 页码：88-93
• 文件大小：995 K

Introduction

Brain atrophy suggests neuroaxonal loss in multiple sclerosis (MS) with the potential to reflect disease progression to a greater extent than lesion measures. The objective of the study was to investigate whether brain atrophy during the first year of disease onset in patients with RRMS, independently predict clinical outcome (development disability during the long term follow up).

Methods

We prospectively included RRMS patients with recently onset of the disease (less than 15 months from the appearance of the first symptom). MRI performed at the onset and after 12 months of the onset of the disease was used to measure the percentage brain atrophy rate between baseline and follow-up scans by means of SIENA software. Progression of the disease was measure with EDSS score. Cox regression test was used to analyze clinical variables and disease progression.

Results

Twenty six patients were included, mean age at onset 32.8 卤 9 years, time to follow up 9.3 卤 5 years. Mean time between first and second MRI scan 13 卤 1.5 months. 42.1%of patients reached an EDSS of or higher than 4. Adjusting by age at onset, gender, oligoclonal band son CSF, lesion load on T2 and immunomodulatory treatment, the higher brain atrophy during the first year of disease onset was significantly related to disease progression during the follow up (p<0.001). Brain atrophy rates in patients that reach EDSS 鈮? was 鈭?.12%vs. 鈭?.28 (p=0.003) in patients that do not reach EDDS 鈮?. Brain atrophy rates higher tan 鈭?.8%was significantly associated with a higher disability on median time (OR 4.2; CI 95%; 2.2-6.5; p=0.008).

Discussion

Brain atrophy rates over 1 year of disease onset was a predictive variable of disease progression in this population.