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01-07-2020 | Multiple Sclerosis | Neuro

2D linear measures of ventricular enlargement may be relevant markers of brain atrophy and long-term disability progression in multiple sclerosis

Authors: Giuseppe Pontillo, Sirio Cocozza, Martina Di Stasi, Antonio Carotenuto, Chiara Paolella, Maria Brunella Cipullo, Teresa Perillo, Elena Augusta Vola, Camilla Russo, Marco Masullo, Marcello Moccia, Roberta Lanzillo, Enrico Tedeschi, Andrea Elefante, Vincenzo Brescia Morra, Arturo Brunetti, Mario Quarantelli, Maria Petracca

Published in: European Radiology | Issue 7/2020

Abstract

Objectives

Aim of this study was to investigate the reliability and validity of 2D linear measures of ventricular enlargement as indirect markers of brain atrophy and possible predictors of clinical disability.

Methods

In this retrospective longitudinal analysis of relapsing-remitting MS patients, brain volumes were computed at baseline and after 2 years. Frontal horn width (FHW), intercaudate distance (ICD), third ventricle width (TVW), and 4th ventricle width were obtained. Two-dimensional measures associated with brain volume at correlation analyses were entered in linear and logistic regression models testing the relationship with baseline clinical disability and 10-year confirmed disability progression (CDP), respectively. Possible cutoff values for clinically relevant atrophy were estimated via receiver operating characteristic (ROC) analyses and probed as 10-year CDP predictors using hierarchical logistic regression.

Results

Eighty-seven patients were available (61/26 = F/M; 34.1 ± 8.5 years). Moderate negative correlations emerged between ICD and TVW and normalized brain volume (NBV; p < 0.001) and percentage brain volume change per year (PBVC/y) and FHW, ICD, and TVW annual changes (p ≤ 0.005). Baseline disability was moderately associated with NBV, ICD, and TVW (p < 0.001), while PBVC/y predicted 10-year CDP (p = 0.01). A cutoff percentage ICD change per year (PICDC/y) value of 4.38%, corresponding to − 0.91% PBVC/y, correlated with 10-year CDP (p = 0.04). These estimated cutoff values provided extra value for predicting 10-year CDP (PBVC/y: p = 0.001; PICDC/y: p = 0.03).

Conclusions

Two-dimensional measures of ventricular enlargement are reproducible and clinically relevant markers of brain atrophy, with ICD and its increase over time showing the best association with clinical disability. Specifically, a cutoff PICDC/y value of 4.38% could serve as a potential surrogate marker of long-term disability progression.

Key Points

• Assessment of ventricular enlargement as a rapidly accessible indirect marker of brain atrophy may prove useful in cases in which brain volume quantification is not practicable.

• Two-dimensional linear measures of ventricular enlargement represent reliable, valid, and clinically relevant markers of brain atrophy.

• A cutoff annualized percentage brain volume change of − 0.91% and the corresponding annualized percentage increase of 4.38% for intercaudate distance are able to discriminate patients who will develop long-term disability progression.

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Title: 2D linear measures of ventricular enlargement may be relevant markers of brain atrophy and long-term disability progression in multiple sclerosis
Authors: Giuseppe Pontillo
Sirio Cocozza
Martina Di Stasi
Antonio Carotenuto
Chiara Paolella
Maria Brunella Cipullo
Teresa Perillo
Elena Augusta Vola
Camilla Russo
Marco Masullo
Marcello Moccia
Roberta Lanzillo
Enrico Tedeschi
Andrea Elefante
Vincenzo Brescia Morra
Arturo Brunetti
Mario Quarantelli
Maria Petracca
Publication date: 01-07-2020
Publisher: Springer Berlin Heidelberg
Keyword: Multiple Sclerosis
Published in: European Radiology / Issue 7/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-06738-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

2D linear measures of ventricular enlargement may be relevant markers of brain atrophy and long-term disability progression in multiple sclerosis

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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