| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
From the Department of Neurology (E.P., B.G., V.Z., G.S., S.S., M.P.A.), University of Florence; Department of Neurological and Behavioral Sciences (M.L.S., M.B., A.G., A.F., N.D.), University of Siena; and Neurology Unit (M.L.B., L.G.), Hospital of Empoli, Italy.
Address correspondence and reprint requests to Dr. Maria Pia Amato, Department of Neurology, University of Florence, Viale Morgagni 85, 50134 Florence, Italy mariapia.amato{at}unifi.it.
Objective: To assess whether neuropsychological tests and MRI measures could be used as predictors of short-term disease evolution in a population of patients with benign multiple sclerosis (B-MS).
Background: The definition of B-MS is controversial. Recent data suggest that neuropsychological tests and MRI measures can provide valuable information for a more correct definition and interpretation of B-MS.
Methods: Sixty-three patients with B-MS (Expanded Disability Status Scale [EDSS] 
3.0 and disease duration 
15 years) underwent neuropsychological assessment using the Rao's Brief Repeatable Neuropsychological Battery and the Stroop Test. At that time, conventional brain MRI and magnetization transfer (MT) imaging was performed. White matter lesion load, global and regional brain volumes, and MT ratio in lesions and normal-appearing brain were measured. After a mean follow-up of 5 years, patients still having an EDSS score 3.5 were classified as still benign, whereas patients who had developed a secondary progressive course or who had an EDSS score 4.0 were defined as no longer benign (NLB).
Results: At end of follow-up, 29% of patients were classified as NLB. Male gender (hazard ratio [HR] = 2.9; 95% confidence interval [CI] 1.2–7.5; p = 0.02), number of neuropsychological tests failed (HR = 1.4; 95% CI 1.1–1.7; p = 0.003), and T1-weighted lesions (HR = 1.3; 95% CI 1.1–1.5; p = 0.002) were related to NLB status. In a model including these 3 variables, the NLB status was predicted with an accuracy of 82%.
Conclusions: Cognitive assessment and MRI metrics can predict short-term disease evolution in benign multiple sclerosis (B-MS). This information can be useful to correctly identify patients with B-MS.
Abbreviations: AC = anterior commissure; B-MS = benign multiple sclerosis; BRB = Brief Repeatable Neuropsychological Battery; CI = confidence interval; EDSS = Expanded Disability Status Scale; HR = hazard ratio; LV = lesion volume; MT = magnetization transfer; MTr = MT ratio; NBV = normalized brain volume; NCV = normalized cortical volumes; NLB = no longer benign; PASAT = Paced Auditory Serial Addition Test; PC = posterior commissure; SB = still benign; SDMT = Symbol Digit Modalities Test; SP = secondary progressive; SPART = Spatial Recall Test; SRT = Selective Reminding Test; ST = Stroop Test; TE = echo time; TR = repetition time; WLG = Word List Generation.
e-Pub ahead of print on July 29, 2009, at www.neurology.org.
Supported in part by a grant of the Associazione Italiana Sclerosi Multipla (AISM).
Disclosure: Author disclosures are provided at the end of the article.
Received January 19, 2009. Accepted in final form April 22, 2009.
Related Article
Neurology 2009 73: 494-495.
This article has been cited by other articles:
|
|
 |
|
  R. H.B. Benedict and F. Fazekas Benign or not benign MS: A role for routine neuropsychological assessment? Neurology, August 18, 2009; 73(7): 494 - 495. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
