Functional Disability and Brain MRI Volumetry Results among Multiple Sclerosis Patients during 5-Year Follow-Up

Sintija Strautmane (Coresponding Author), Arturs Balodis, Agnete Teivāne, Dagnija Grabovska, Edgars Naudiņš, Daniels Urbanovics, Edgars Fišermans, Jānis Mednieks, Alīna Flintere-Flinta, Zanda Priede, Andrejs Millers, Maksims Zolovs

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Background and Objectives: We aimed to determine the link between brain volumetry
results and functional disability calculated using the Expanded Disability Status Scale (EDSS) among
multiple sclerosis (MS) patients in relation to the provided treatment (disease-modifying therapies
(DMTs)) during a 5-year follow-up period. Materials and Methods: A retrospective cohort study
was performed enrolling 66 consecutive patients with a confirmed diagnosis of MS, predominantly
females (62% (n = 41)). Relapsing–remitting (RR) MS was noted in 92% (n = 61) of patients, with the
rest being patients with secondary progressive (SP) MS. The mean age was 43.3 years (SD 8.3 years).
All patients were evaluated clinically using the EDSS and “FreeSurfer© 7.2.0” radiologically during a
5-year follow-up. Results: A significant increase in patient functional disability was noted, calculated
using the EDSS during a 5-year follow-up. The baseline EDSS ranged between 1 and 6 with a median
of 1.5 (IQR 1.5–2.0), and after 5 years, the EDSS was between 1 and 7, with a median EDSS of 3.0
(IQR 2.4–3.6). Compared with RRMS patients, SPMS patients demonstrated a significant increase in
EDSS score during a 5-year period, with a median EDSS of 2.5 in RRMS patients (IQR 2.0–3.3) and 7.0
(IQR 5.0–7.0) among SPMS patients. Significantly lower brain volumetry results in different brain
areas were found, including cortical, total grey and white matter, p < 0.05. Statistically significant
differences were observed between baseline volumetry results of the hippocampus and the middle
anterior part of the corpus callosum and their volumetry results after 5 years, p < 0.001. In this
study population, the thalamus did not demonstrate significant changes in volumetry results during
follow-up, p > 0.05. The provided treatment (DMTs) did not demonstrate a significant impact on the
brain MRI volumetry results during a 5-year follow-up, p > 0.05. Conclusions: Brain MRI volumetry
seriously impacts the early detection of brain atrophic changes. In this study, significant relationship
between brain magnetic resonance volumetry results and disability progression among MS patients
with no important impact of the provided treatment was described. Brain MRI volumetry may aid
in the identification of early disease progression among MS patients, as well as enrich the clinical
evaluation of MS patients in clinical patient care.
Original languageEnglish
Article number1082
Number of pages12
Issue number6
Publication statusPublished - 4 Jun 2023


  • multiple sclerosis
  • brain atrophy
  • MRI
  • EDSS
  • disability

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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