The University of Texas Health Science Center at Houston
Neurology

Author Of 1 Presentation

Imaging Poster Presentation

P0630 - Racial/ethnic disparities in volumetric MRI correlates of clinical disability between Hispanic/Latino and Caucasian multiple sclerosis patients (ID 564)

Speakers
Presentation Number
P0630
Presentation Topic
Imaging

Abstract

Background

Magnetic resonance imaging (MRI)-based measures have been established as robust, non-invasive, in vivo biomarkers of disease. Although the relationship between quantitative regional MRI volume measures and selected aspects of clinical disability in MS has been described, characterization of specific trends by race/ethnicity is lacking.

Objectives

To characterize racial disparities in disability-specific patterns of MRI-based volumetric measures between Hispanic and non-Hispanic Caucasian individuals with MS and explore the relevance of regional brain volumetric measures as predictors of clinical disability progression.

Methods

MRI from 94 Hispanic and 94 Caucasian MS patients was analyzed using automatic and manual brain segmentation techniques. Scans were done between January 2010 and December 2019 on a single 3.0-Tesla scanner using a standardized imaging protocol. Whole brain, cortex, white matter, basal ganglia, thalamus, corpus callosum, lateral ventricular, and T2 lesion volumes were measured and compared with the extent of neurological impairment as measured by Expanded Disability Status Scale (EDSS) scores at baseline and in subsequent follow-up visits. Cox proportional hazard regression models determined the predictive value of baseline MRI metrics for sustained EDSS progression in a time-to-event analysis.

Results

At baseline, Hispanic patients had a higher median EDSS score (median [IQR], 2.0; [1.0–3.5]) compared to Caucasians (median [IQR], 1.0 [0.0–2.0]). In addition, Hispanics were found to develop more rapid accumulation of clinical disability and an increased risk of requiring assistance to ambulate (hazard ratio (HR), 9.7; 95% confidence interval (CI), 2.8–32.5). T2 lesion volume was associated with EDSS in Hispanics (rs = .38, p < .001), and white matter volume was moderately correlated with disability in Caucasians only (rs = -.41, p < .001). The association between normalized thalamic volume and EDSS scores was moderate in both (rs = -.42, P < .001 in Hispanics and rs = -.32, P = .002 in Caucasians). Baseline thalamic volume was the best predictor of sustained disability worsening in both. Patients with thalamic volumes below the mean had a higher risk for progression, with greater risk in Hispanics (HR, 7.9; 95% CI, 3.5–17.9) compared to Caucasians (HR, 3.0; 95% CI, 1.5–6.4).

Conclusions

Quantitative MRI assessment of brain and lesion volume is a useful tool to explore the influence of race on clinical disease expression in multiple sclerosis. Racial disparities in baseline volumetric MRI correlates of clinical disability suggest a burgeoning trend of possibly differentially regulated pathophysiologic processes through which race-dependent disparities may manifest. The confounding impact of race and ethnicity on brain volumetric measures may affect the interpretation of outcome measures in clinical MS studies and should be controlled in randomized clinical trials.

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Presenter Of 1 Presentation

Imaging Poster Presentation

P0630 - Racial/ethnic disparities in volumetric MRI correlates of clinical disability between Hispanic/Latino and Caucasian multiple sclerosis patients (ID 564)

Speakers
Presentation Number
P0630
Presentation Topic
Imaging

Abstract

Background

Magnetic resonance imaging (MRI)-based measures have been established as robust, non-invasive, in vivo biomarkers of disease. Although the relationship between quantitative regional MRI volume measures and selected aspects of clinical disability in MS has been described, characterization of specific trends by race/ethnicity is lacking.

Objectives

To characterize racial disparities in disability-specific patterns of MRI-based volumetric measures between Hispanic and non-Hispanic Caucasian individuals with MS and explore the relevance of regional brain volumetric measures as predictors of clinical disability progression.

Methods

MRI from 94 Hispanic and 94 Caucasian MS patients was analyzed using automatic and manual brain segmentation techniques. Scans were done between January 2010 and December 2019 on a single 3.0-Tesla scanner using a standardized imaging protocol. Whole brain, cortex, white matter, basal ganglia, thalamus, corpus callosum, lateral ventricular, and T2 lesion volumes were measured and compared with the extent of neurological impairment as measured by Expanded Disability Status Scale (EDSS) scores at baseline and in subsequent follow-up visits. Cox proportional hazard regression models determined the predictive value of baseline MRI metrics for sustained EDSS progression in a time-to-event analysis.

Results

At baseline, Hispanic patients had a higher median EDSS score (median [IQR], 2.0; [1.0–3.5]) compared to Caucasians (median [IQR], 1.0 [0.0–2.0]). In addition, Hispanics were found to develop more rapid accumulation of clinical disability and an increased risk of requiring assistance to ambulate (hazard ratio (HR), 9.7; 95% confidence interval (CI), 2.8–32.5). T2 lesion volume was associated with EDSS in Hispanics (rs = .38, p < .001), and white matter volume was moderately correlated with disability in Caucasians only (rs = -.41, p < .001). The association between normalized thalamic volume and EDSS scores was moderate in both (rs = -.42, P < .001 in Hispanics and rs = -.32, P = .002 in Caucasians). Baseline thalamic volume was the best predictor of sustained disability worsening in both. Patients with thalamic volumes below the mean had a higher risk for progression, with greater risk in Hispanics (HR, 7.9; 95% CI, 3.5–17.9) compared to Caucasians (HR, 3.0; 95% CI, 1.5–6.4).

Conclusions

Quantitative MRI assessment of brain and lesion volume is a useful tool to explore the influence of race on clinical disease expression in multiple sclerosis. Racial disparities in baseline volumetric MRI correlates of clinical disability suggest a burgeoning trend of possibly differentially regulated pathophysiologic processes through which race-dependent disparities may manifest. The confounding impact of race and ethnicity on brain volumetric measures may affect the interpretation of outcome measures in clinical MS studies and should be controlled in randomized clinical trials.

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