Predictors of early disability accumulation in newly diagnosed multiple sclerosis: clinical, imaging and cerebrospinal fluid measures

被引:1
作者
Lauerer, Markus [1 ,2 ]
Wiltgen, Tun [1 ,2 ]
Brueckner, Carolin [1 ]
Engl, Christina [1 ]
Giglhuber, Katrin [1 ]
Lambrecht, Sebastian [1 ]
Pongratz, Viola [1 ,2 ]
Berthele, Achim [1 ]
Gasperi, Christiane [1 ]
Kirschke, Jan S. [3 ]
Zimmer, Claus [3 ]
Hemmer, Bernhard [1 ,4 ]
Muhlau, Mark [1 ,2 ]
机构
[1] Tech Univ Munich, Sch Med & Hlth, Dept Neurol, Munich, Germany
[2] Tech Univ Munich, TUM Neuroimaging Ctr, Sch Med & Hlth, Munich, Germany
[3] Tech Univ Munich, Sch Med & Hlth, Dept Neuroradiol, Munich, Germany
[4] Munich Cluster Syst Neurol SyNergy, Munich, Germany
关键词
MULTIPLE SCLEROSIS; MRI; CSF; CLINICAL NEUROLOGY; NEUROIMMUNOLOGY; EVOLUTION;
D O I
10.1136/jnnp-2024-335037
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background A growing arsenal of treatment options for relapsing multiple sclerosis (RMS) emphasises the need for early prognostic biomarkers. While evidence for individual markers exists, comprehensive analyses at the time of diagnosis are sparse.Methods Brain and spinal cord lesion numbers, cerebrospinal fluid parameters, initial symptoms, and Expanded Disability Status Scale (EDSS) score were determined at the time of diagnosis. Confirmed disability accumulation (CDA), defined as a sustained EDSS increase over 6 months, was determined during a 5-year follow-up. All-subsets multivariable logistic regression was performed to identify predictors of CDA. Model performance was assessed via receiver operating characteristic analysis, and individual risks were calculated. Analyses were repeated with progression independent of relapse activity (PIRA) as an outcome.Results 113/417 (27.1%) people with RMS experienced CDA on follow-up. Intrathecal IgG synthesis, a higher number of spinal cord lesions, age and polysymptomatic manifestation were identified as independent predictors of CDA. The resulting prediction model yielded an area under the curve (AUC) of 0.75 with a 95% CI of 0.70 to 0.80. Individuals exceeding the optimal thresholds for the three most significant predictors had a 61.8% likelihood of experiencing CDA, whereas those below all three thresholds had a CDA rate of 4.5%. The only significant baseline predictor differentiating PIRA from relapse-associated worsening was a higher number of spinal cord lesions (AUC=0.64, 95% CI 0.54 to 0.74).Conclusions Intrathecal IgG synthesis, spinal cord lesion number, age and polysymptomatic manifestation are independent predictors of early CDA in newly diagnosed RMS.
引用
收藏
页数:8
相关论文
共 50 条
[41]   Integrative biochemical, proteomics and metabolomics cerebrospinal fluid biomarkers predict clinical conversion to multiple sclerosis [J].
Probert, Fay ;
Yeo, Tianrong ;
Zhou, Yifan ;
Sealey, Megan ;
Arora, Siddharth ;
Palace, Jacqueline ;
Claridge, Timothy D. W. ;
Hillenbrand, Rainer ;
Oechtering, Johanna ;
Leppert, David ;
Kuhle, Jens ;
Anthony, Daniel C. .
BRAIN COMMUNICATIONS, 2021, 3 (02)
[42]   Tau protein level in cerebrospinal fluid is increased in patients with early multiple sclerosis [J].
Brettschneider, J ;
Maier, M ;
Arda, S ;
Claus, A ;
Süssmuth, SD ;
Kassubek, J ;
Tumani, H .
MULTIPLE SCLEROSIS JOURNAL, 2005, 11 (03) :261-265
[43]   Cerebrospinal Fluid Flow Dynamics in Multiple Sclerosis Patients through Phase Contrast Magnetic Resonance Imaging [J].
Lagana, Maria Marcella ;
Chaudhary, Anamika ;
Balagurunathan, Deepa ;
Utriainen, David ;
Kokeny, Paul ;
Feng, Wei ;
Cecconi, Pietro ;
Hubbard, David ;
Haacke, E. Mark .
CURRENT NEUROVASCULAR RESEARCH, 2014, 11 (04) :349-358
[44]   Oligoclonal bands in multiple sclerosis cerebrospinal fluid: An update on methodology and clinical usefulness [J].
Link, Hans ;
Huang, Yu-Min .
JOURNAL OF NEUROIMMUNOLOGY, 2006, 180 (1-2) :17-28
[45]   Decreased Level of sRAGE in the Cerebrospinal Fluid of Multiple Sclerosis Patients at Clinical Onset [J].
Glasnovic, Anton ;
Cvija, Hrvoje ;
Stojic, Maristela ;
Tudoric-Deno, Ivana ;
Ivcevic, Sanja ;
Romic, Dominik ;
Ticinovic, Nino ;
Vuletic, Vladimira ;
Lazibat, Ines ;
Grcevic, Danka .
NEUROIMMUNOMODULATION, 2014, 21 (05) :226-233
[46]   Clinical and cognitive implications of cerebrospinal fluid oligoclonal bands in multiple sclerosis patients [J].
Maria Anagnostouli ;
Foteini Christidi ;
Ioannis Zalonis ;
Chryssoula Nikolaou ;
Dimitrios Lyrakos ;
Nikolaos Triantafyllou ;
Ioannis Evdokimidis ;
Constantinos Kilidireas .
Neurological Sciences, 2015, 36 :2053-2060
[47]   Serum and cerebrospinal fluid soluble Fas levels in clinical subgroups of multiple sclerosis [J].
Boylan, MT ;
Crockard, AD ;
McDonnell, GV ;
McMillan, SA ;
Hawkins, SA .
IMMUNOLOGY LETTERS, 2001, 78 (03) :183-187
[48]   Effects of Natalizumab and Fingolimod on Clinical, Cognitive, and Magnetic Resonance Imaging Measures in Multiple Sclerosis [J].
Preziosa, Paolo ;
Rocca, Maria A. ;
Riccitelli, Gianna C. ;
Moiola, Lucia ;
Storelli, Loredana ;
Rodegher, Mariaemma ;
Comi, Giancarlo ;
Signori, Alessio ;
Falini, Andrea ;
Filippi, Massimo .
NEUROTHERAPEUTICS, 2020, 17 (01) :208-217
[49]   Effects of Natalizumab and Fingolimod on Clinical, Cognitive, and Magnetic Resonance Imaging Measures in Multiple Sclerosis [J].
Paolo Preziosa ;
Maria A. Rocca ;
Gianna C. Riccitelli ;
Lucia Moiola ;
Loredana Storelli ;
Mariaemma Rodegher ;
Giancarlo Comi ;
Alessio Signori ;
Andrea Falini ;
Massimo Filippi .
Neurotherapeutics, 2020, 17 :208-217
[50]   Gait and balance impairment in early multiple sclerosis in the absence of clinical disability [J].
Martin, C. L. ;
Phillips, B. A. ;
Kilpatrick, T. J. ;
Butzkueven, H. ;
Tubridy, N. ;
McDonald, E. ;
Galea, M. P. .
MULTIPLE SCLEROSIS JOURNAL, 2006, 12 (05) :620-628