医学
扩大残疾状况量表
多发性硬化
磁共振成像
胼胝体
危险系数
比例危险模型
内科学
病变
临床试验
放射科
置信区间
病理
精神科
作者
Tomáš Uher,Manuela Vaněčková,Lukáš Sobíšek,Michaela Týblová,Zdeněk Seidl,Jan Krásenský,Deepa Ramasamy,Robert Zivadinov,Eva Havrdová,Tomáš Kalinčík,Dana Horáková
标识
DOI:10.1177/1352458516642314
摘要
Background: Disease progression and treatment efficacy vary among individuals with multiple sclerosis. Reliable predictors of individual disease outcomes are lacking. Objective: To examine the accuracy of the early prediction of 12-year disability outcomes using clinical and magnetic resonance imaging (MRI) parameters. Methods: A total of 177 patients from the original Avonex-Steroids-Azathioprine study were included. Participants underwent 3-month clinical follow-ups. Cox models were used to model the associations between clinical and MRI markers at baseline or after 12 months with sustained disability progression (SDP) over the 12-year observation period. Results: At baseline, T2 lesion number, T1 and T2 lesion volumes, corpus callosum (CC), and thalamic fraction were the best predictors of SDP (hazard ratio (HR) = 1.7–4.6; p ⩽ 0.001–0.012). At 12 months, Expanded Disability Status Scale (EDSS) and its change, number of new or enlarging T2 lesions, and CC volume % change were the best predictors of SDP over the follow-up (HR = 1.7–3.5; p ⩽ 0.001–0.017). A composite score was generated from a subset of the best predictors of SDP. Scores of ⩾4 had greater specificity (90%–100%) and were associated with greater cumulative risk of SDP (HR = 3.2–21.6; p < 0.001) compared to the individual predictors. Conclusion: The combination of established MRI and clinical indices with MRI volumetric predictors improves the prediction of SDP over long-term follow-up and may provide valuable information for therapeutic decisions.
科研通智能强力驱动
Strongly Powered by AbleSci AI