Author Of 1 Presentation
P0067 - Disability improvement by Multiple Sclerosis Functional Composite in progressive MS patients and MRI features (ID 1729)
Disability improvement is an important functional measure in progressive MS. The MRI features of disability improvement have not been explored.
To assess quantitative brain and spinal cord MRI measures, including volumetric features, that correlate with improvement in the T25FW or 9HPT compared to multiple sclerosis (MS) patients with stable or worsening features.
A nested cohort from the SysteMS substudy of Comprehensive Longitudinal Investigations in MS at Brigham and Women’s Hospital (CLIMB) Study was selected to match inclusion criteria for patients enrolling in a phase 2 trial of repeat dose intrathecal Mesenchymal Stem Cells-Neurotrophic Factor (MSC-NTF) cells in patients with progressive MS (NCT03799718). 3T MRIs at baseline and at follow-up timepoint (12-24 months later) underwent brain and lesion volumetric analysis by Icometrix, as well as mean upper cervical cord area (MUCCA) which generated 34 measures. These 34 MRI volumetric measures (ml) were compared in patients with improved versus patients with worsening or stable 9-hole peg test (9HPT) or timed-25-foot-walk (T25FW) scores. Results were not corrected for multiple comparisons due to the exploratory nature of this study.
48 patients met inclusion criteria. 17 patients had improved 9HPT score, while 29 had worsened or had stable 9HPT score from baseline to 12-24 months later. Whole brain volume at baseline for these 3 cohorts (Improved 9HPT:1505±51 vs. stable-worse 9HPT:1471±62;p=0.069;t-test) and follow-up (Improved:1501.555±52.039 vs. stable-worse:1461.304±63.562);p=0.03;t-test) differed between the two groups, as did gray matter volume at follow-up (Improved 1505.059 ±50.961 vs. stable-worse 865.57±41.352); p=0.063:t-test). For T25FW, 18 patients had an improved score, while 27 were worsened or stable over the 12-month period. Deep white matter FLAIR/T2 lesion volume at baseline (Improved:0.43±0.507 vs. stable-worse:0.827±0.561;p=0.03;t-test) and follow-up (Improved:0.429±0.503 vs. stable-worse:0.864±0.603;p=0.02) differed between two T25FW groups. MUCCA was not associated with improvement measures.
Improved 9HPT measures over a 12-month period correlated with baseline brain volume, while T25FW improvements correlated with baseline deep white matter T2 lesion volume. These results will inform analysis of clinical outcomes in the ongoing phase 2 clinical trial of MSC-NTF cells in progressive MS.