Clinical disability and smoking are associated with MRI disease activity in progressive multiple sclerosis
Author(s): ,
C Ammitzbøll
Affiliations:
Danish Multiple Sclerosis Center, Copenhagen University Hospital Rigshospitalet, Copenhagen
,
T Dyrby
Affiliations:
Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Hvidovre
,
M Lyksborg
Affiliations:
Department of Applied Mathematics and Computer Science, Technical University of Denmark, Lyngby
,
K Schreiber
Affiliations:
Danish Multiple Sclerosis Center, Copenhagen University Hospital Rigshospitalet, Copenhagen
,
R Ratzer
Affiliations:
Danish Multiple Sclerosis Center, Copenhagen University Hospital Rigshospitalet, Copenhagen
,
J Romme Christensen
Affiliations:
Danish Multiple Sclerosis Center, Copenhagen University Hospital Rigshospitalet, Copenhagen
,
P Iversen
Affiliations:
Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Hvidovre
,
M Magyari
Affiliations:
Danish Multiple Sclerosis Center, Copenhagen University Hospital Rigshospitalet, Copenhagen
,
E Garde
Affiliations:
Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Hvidovre
,
P.S Sørensen
Affiliations:
Danish Multiple Sclerosis Center, Copenhagen University Hospital Rigshospitalet, Copenhagen
,
H.R Siebner
Affiliations:
Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Hvidovre;Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
F Sellebjerg
Affiliations:
Danish Multiple Sclerosis Center, Copenhagen University Hospital Rigshospitalet, Copenhagen
ECTRIMS Online Library. Ammitzbøll C. 09/16/16; 145706; P1022
Cecilie Ammitzbøll
Cecilie Ammitzbøll
Contributions
Abstract

Abstract: P1022

Type: Poster

Abstract Category: Pathology and pathogenesis of MS - Imaging

Background: In multiple sclerosis (MS), smoking is a possible risk factor for disease progression. In progressive MS, data on the relationship between magnetic resonance imaging (MRI) measures and clinical disability and smoking are scarce.

Objective: To investigate the relationship between clinical disability and MRI measures and the impact of smoking on MRI measures in progressive MS, using conventional and unconventional MRI techniques.

Methods: In a cross-sectional study, we studied baseline clinical and MRI data from 93 patients with progressive MS. Thirty-seven patients had primary progressive MS and 56 patients had secondary progressive MS. Patients were categorised as current smokers or non-smokers. All patients had assessment of Expanded Disability Status Scale (EDSS) scores and multiple sclerosis functional composite (MSFC) scores, including 9-hole peg test (9HPT), timed 25 foot walk (T25FW) and paced auditory serial addition test (PASAT). From 3T MRI scans, T2 lesion volume was extracted and estimated microstructural changes in lesions, normal appearing white matter (NAWM) and cortical grey matter (CGM) were assessed based on magnetisation transfer ratio (MTR) and diffusion weighted imaging (fractional anisotropy (FA) and mean diffusivity (MD)). The relationship between clinical disability scores and MRI measures was assessed by correlation analyses and corrected for multiple comparisons by calculation of false discovery rates (q-values). The effect of smoking on MRI measures was analysed by univariate analyses of covariance, adjusted for relevant covariates.

Results: Lesion volumes correlated with all clinical measures: EDSS (ρ=0.286, q=0.043), 9HPT (ρ=0.312, q=0.041), T25FW (ρ=0.313, q=0.047) and PASAT (ρ=-0.303, q=0.044). MTR in lesions correlated with EDSS (ρ=-0.278, q=0.048), and MD values in lesions correlated with T25FW (ρ=0.278, q=0.049) and PASAT scores (ρ=-0.356, q=0.025). In NAWM, FA values correlated with 9HPT (ρ=-0.359, q=0.043). Finally, in patients who were smokers, FA in NAWM was lower than in non-smokers (p=0.019).

Conclusion: In progressive MS, clinical disability is associated with increased T2 lesion volume and microstructural changes in lesions consistent with demyelination. Relationships between microstructural changes in NAWM and clinical measures are less pronounced, but smoking is associated with reduced FA values in NAWM of patients with progressive MS, suggesting that microstructural damage is accelerated by smoking.

Disclosure: Cecilie Ammitzbøll has received travel support from Biogen Idec, Genzyme, Teva and Merck Serono

Tim Dyrby has nothing to disclose

Mark Lyksborg has nothing to disclose

Karen Shreiber has received support for congress participation from Biogen, Genzyme, Merck Serono, Novartis and Teva, and served on advisory board for Novartis

Rikke Ratzer had travel expenses reimbursed by Biogen Idec and Genzyme

Jeppe Romme Christensen has received speaker honoraria from Novartis and TEVA, consultant honoraria from Biogen Idec and TEVA , and has had travel expenses reimbursed by Biogen Idec.

Pernille Iversen has received meeting registration fees and speaker honoraria from Biogen Idec.

Melinda Magyari has served on scientific advisory board for Biogen Idec and Novartis, Merck Serono, has received honoraria for lecturing from Biogen Idec, Merck Serono, Novartis, Genzyme, has received support for congress participation from Biogen Idec, Novartis, Genzyme, Teva.

Ellen Garde has received speaker honoraria and has had travel expenses reimbursed by Biogen Idec.

Per S. Sørensen has received personal compensation for serving on scientific advisory boards, steering committees or independent data monitoring boards for Biogen Idec, Merck Serono, Novartis, Genzyme, Teva Pharmaceutical Industries Ltd., GlaxoSmithKline, medDay Pharmaceuticals and Forward Pharma and has received speaker honoraria from Biogen Idec, Merck Serono, Teva Pharmaceutical Industries Ltd., Genzyme, and Novartis.

Hartwig R. Siebner has served on a scientific advisory board for Lundbeck A/S, Valby Denmark, and has received honoraria as speaker from Biogen Idec, Denmark A/S, Genzyme, Denmark and Merck Serono, Denmark, has received honoraria as editor from Elsevier Publishers, Amsterdam, The Netherlands and Springer Publishing, Stuttgart, Germany, has received travel support from MagVenture, Denmark, and has received a research fund from Biogen-idec.

Finn Sellebjerg has served on scientific advisory boards, been on the steering committees of clinical trials, served as a consultant, received support for congress participation, received speaker honoraria, or received research support for his laboratory from Biogen, EMD Serono, Genzyme, Lundbeck, Merck Serono, Novartis and Teva.

Abstract: P1022

Type: Poster

Abstract Category: Pathology and pathogenesis of MS - Imaging

Background: In multiple sclerosis (MS), smoking is a possible risk factor for disease progression. In progressive MS, data on the relationship between magnetic resonance imaging (MRI) measures and clinical disability and smoking are scarce.

Objective: To investigate the relationship between clinical disability and MRI measures and the impact of smoking on MRI measures in progressive MS, using conventional and unconventional MRI techniques.

Methods: In a cross-sectional study, we studied baseline clinical and MRI data from 93 patients with progressive MS. Thirty-seven patients had primary progressive MS and 56 patients had secondary progressive MS. Patients were categorised as current smokers or non-smokers. All patients had assessment of Expanded Disability Status Scale (EDSS) scores and multiple sclerosis functional composite (MSFC) scores, including 9-hole peg test (9HPT), timed 25 foot walk (T25FW) and paced auditory serial addition test (PASAT). From 3T MRI scans, T2 lesion volume was extracted and estimated microstructural changes in lesions, normal appearing white matter (NAWM) and cortical grey matter (CGM) were assessed based on magnetisation transfer ratio (MTR) and diffusion weighted imaging (fractional anisotropy (FA) and mean diffusivity (MD)). The relationship between clinical disability scores and MRI measures was assessed by correlation analyses and corrected for multiple comparisons by calculation of false discovery rates (q-values). The effect of smoking on MRI measures was analysed by univariate analyses of covariance, adjusted for relevant covariates.

Results: Lesion volumes correlated with all clinical measures: EDSS (ρ=0.286, q=0.043), 9HPT (ρ=0.312, q=0.041), T25FW (ρ=0.313, q=0.047) and PASAT (ρ=-0.303, q=0.044). MTR in lesions correlated with EDSS (ρ=-0.278, q=0.048), and MD values in lesions correlated with T25FW (ρ=0.278, q=0.049) and PASAT scores (ρ=-0.356, q=0.025). In NAWM, FA values correlated with 9HPT (ρ=-0.359, q=0.043). Finally, in patients who were smokers, FA in NAWM was lower than in non-smokers (p=0.019).

Conclusion: In progressive MS, clinical disability is associated with increased T2 lesion volume and microstructural changes in lesions consistent with demyelination. Relationships between microstructural changes in NAWM and clinical measures are less pronounced, but smoking is associated with reduced FA values in NAWM of patients with progressive MS, suggesting that microstructural damage is accelerated by smoking.

Disclosure: Cecilie Ammitzbøll has received travel support from Biogen Idec, Genzyme, Teva and Merck Serono

Tim Dyrby has nothing to disclose

Mark Lyksborg has nothing to disclose

Karen Shreiber has received support for congress participation from Biogen, Genzyme, Merck Serono, Novartis and Teva, and served on advisory board for Novartis

Rikke Ratzer had travel expenses reimbursed by Biogen Idec and Genzyme

Jeppe Romme Christensen has received speaker honoraria from Novartis and TEVA, consultant honoraria from Biogen Idec and TEVA , and has had travel expenses reimbursed by Biogen Idec.

Pernille Iversen has received meeting registration fees and speaker honoraria from Biogen Idec.

Melinda Magyari has served on scientific advisory board for Biogen Idec and Novartis, Merck Serono, has received honoraria for lecturing from Biogen Idec, Merck Serono, Novartis, Genzyme, has received support for congress participation from Biogen Idec, Novartis, Genzyme, Teva.

Ellen Garde has received speaker honoraria and has had travel expenses reimbursed by Biogen Idec.

Per S. Sørensen has received personal compensation for serving on scientific advisory boards, steering committees or independent data monitoring boards for Biogen Idec, Merck Serono, Novartis, Genzyme, Teva Pharmaceutical Industries Ltd., GlaxoSmithKline, medDay Pharmaceuticals and Forward Pharma and has received speaker honoraria from Biogen Idec, Merck Serono, Teva Pharmaceutical Industries Ltd., Genzyme, and Novartis.

Hartwig R. Siebner has served on a scientific advisory board for Lundbeck A/S, Valby Denmark, and has received honoraria as speaker from Biogen Idec, Denmark A/S, Genzyme, Denmark and Merck Serono, Denmark, has received honoraria as editor from Elsevier Publishers, Amsterdam, The Netherlands and Springer Publishing, Stuttgart, Germany, has received travel support from MagVenture, Denmark, and has received a research fund from Biogen-idec.

Finn Sellebjerg has served on scientific advisory boards, been on the steering committees of clinical trials, served as a consultant, received support for congress participation, received speaker honoraria, or received research support for his laboratory from Biogen, EMD Serono, Genzyme, Lundbeck, Merck Serono, Novartis and Teva.

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