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A validation study of manual atrophy measures in patients with Multiple Sclerosis

  • Diagnostic Neuroradiology
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Abstract

Purpose

Manual measures such as corpus callosum index, normalized corpus callosum area, and width of the third ventricle are potential biomarkers for brain atrophy. In this work, we investigate their suitability to assess the neurodegenerative component of multiple sclerosis (MS) by comparing them to volumetric measures and expanded disability status scale (EDSS).

Methods

Fifty-eight patients with a clinically isolated syndrome, 48 MS patients treated with interferon β, and 26 treated with natalizumab underwent a brain MRI at baseline and after 1 year. Manual measures were evaluated by two observers using Jim v.6.0 at both time points. Volumetric tools (SIENA/x and Freesurfer) were used to calculate normalized brain volume, brain parenchymal fraction, annualized percentage of brain volume change, corpus callosum volume, ventricle volume, and volume of the third ventricle. Statistical analyses were performed with SPSS v.13.

Results

Usage of corpus callosum volume and third ventricle volume to validate normalized corpus callosum area and width of the third ventricle, respectively, showed very good correlations (r = 0.85, r = 0.83; p < 0.01). Width of the third ventricle, corpus callosum index, and normalized corpus callosum area correlations were significant with EDSS in all patients and moderate to strong with normalized brain volume and brain parenchymal fraction in natalizumab-treated patients (respectively r = − 0.54, r = − 0.61; r = 0.55, r = 0.67; and r = 0.58, r = 0.67; with p < 0.05).

Conclusion

Width of the third ventricle and normalized corpus callosum area seem the more robust manual measures regarding correlation with volumetric measures and EDSS, especially in patients with more advanced disease.

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Acknowledgements

The authors would like to thank L. Cockmartin from the Department of Radiology from the University Hospital Leuven for her support during the statistical analysis. A special thanks goes to all patients participated in the study.

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Authors and Affiliations

  1. Section of Neuroradiology and Magnetic Resonance Unit, Department of Radiology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

    Sarah Cappelle, Deborah Pareto, Manel Alberich, Cristina Auger & Àlex Rovira

  2. Department of Radiology, University Hospital Leuven, Leuven, Belgium

    Sarah Cappelle

  3. Department of Neurology/Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

    Mar Tintoré, Angela Vidal-Jordana, Rumaiza Alyafeai, Jaume Sastre-Garriga & Xavier Montalban

  4. Division of Neurology, St Michael’s Hospital, University of Toronto, Toronto, Canada

    Xavier Montalban

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  1. Sarah Cappelle
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  2. Deborah Pareto
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Corresponding authors

Correspondence to Deborah Pareto or Àlex Rovira.

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Conflict of interest

S. Cappelle declares that she has no conflict of interest. D. Pareto has received a speaker honorarium from Novartis and Sanofi-Genzyme. M. Tintoré has received a speaker honorarium and travel expenses for participation in scientific meetings or advisory boards in past years from Almirall, Bayer, Biogen, EMD Serono, Genzyme, Merck, Novartis, Roche, Sanofi-Genzyme, Teva Pharmaceutical, VielaBio, and Excemed. A. Vidal-Jordana has received honoraria as speaker and/or for participation in Advisory Boards from Novartis, Roche, Sanofi-Genzyme, and Biogen. R. Alyafeai has been awarded the McDonald fellowship from MSIF. M. Alberich declares that he has no conflict of interest. J. Sastre-Garriga has received grants and personal fees from Genzyme, personal fees from Almirall, Biogen, Celgene, Merck, Novartis, Roche, and Teva. He declares being a member of the Editorial Committee of the MS Journal for which he receives a personal fee and Director of the Scientific Committee of Revista de Neurología, for which he does not receive any personal fee. C. Auger declares that she has no conflict of interest. X. Montalban has received a speaker honorarium and travel expenses for participation in scientific meetings or advisory boards in past years from Actelion, Alexion, Bayer, Biogen, Celgene, EMD Serono, Genzyme, Medday, Merck, Nervgen, Novartis, Roche, Sanofi-Genzyme, Teva Pharmaceutical, TG Therapeutics, Excemed, MSIF, and NMSS. A. Rovira has received a speaker honorarium from Bayer, Sanofi-Genzyme, Bracco, Merck-Serono, Teva Pharmaceutical Industries Ltd., Novartis, Roche, and Biogen. He serves on scientific advisory boards for Novartis, Sanofi-Genzyme, SyntheticMR, Bayer, Roche, Biogen, Neurodiem, and OLEA Medical.

Ethical approval

This study was in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Cappelle, S., Pareto, D., Tintoré, M. et al. A validation study of manual atrophy measures in patients with Multiple Sclerosis. Neuroradiology 62, 955–964 (2020). https://doi.org/10.1007/s00234-020-02401-3

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  • DOI: https://doi.org/10.1007/s00234-020-02401-3

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