Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Brain Volume Loss as Therapeutic Response Marker

JAMA Neurology; ePub 2018 Jul 2; Andorra, et al

Before using brain volume loss (BVL) as a marker of therapeutic response in multiple sclerosis (MS), certain biological and methodological issues must be clarified. This according to a recent study that assessed the dynamics of BVL as MS progresses and evaluated the repeatability and exchangeability of BVL estimates. A cohort of patients (n=140) who had either clinically isolated syndrome or MS underwent a series of annual MRI scans. Images from 2 cohorts of healthy volunteers were used to evaluate short-term repeatability of the MRI measurements (n=34) and annual BVL (n=20). Researchers found:

  • The BVL rates were higher in the first 5 years after MS onset with a direct association with steroids and an inverse association with age at MS onset, particularly in the first 5 years.
  • Considering an expected loss of 0.5% to 1.35% per year, the poor repeatability of 2 separate imaging methods prevents their use at the individual level; also, volumetric estimates and the accuracy of thresholds to discriminate patients with MS from healthy volunteers differ in the 2 approaches.

Andorra M, Nakamura K, Lampert EJ, et al. Assessing biological and methodological aspects of brain volume loss in multiple sclerosis. [Published online ahead of print July 2, 2018]. JAMA Neurology. doi:10.1001/jamaneurol.2018.1596.

This Week's Must Reads

Stroke Care Comparison of Asian Americans and Whites, JAMA Neurology; ePub 2019 Jan 22; Song, Liang, et al

Aerobic Exercise Can Improve Executive Functioning , Neurology; 2019 Jan 15; Blumenthal, et al

Episodic Memory Decline is Neurodegenerative Marker, Neurology; ePub 2019 Jan 23; Wilson, Yang, et al

Serum Troponin Level Marker for Visceral Infarcts , J Stroke Cerebrovasc Dis; ePub 2019 Jan 18; Azher, et al

Urine Sodium-to-Potassium Ratio Predicts Stroke, Stroke; ePub 2019 Jan 21; Averill, Young, et al

Must Reads in Multiple Sclerosis

Prevalence of Asthma in Persons with MS, Mult Scler Relat Disord; ePub 2018 Dec 11; Hill, et al

Normal-Appearing White Matter in MS Examined, Neuroradiology; ePub 2018 Dec 12; Yu, et al

MS Disease Burden: Which Symptoms Matter Most?, Mult Scler Relat Disord; 2018 Oct; Barin, et al

Retinal Layer Thickness and MS Conversion Risk, Mult Scler; ePub 2018 Dec 3; Filippatou, et al

Importance of Coping and QOL in People with MS, Int J MS Care; ePub 2018 Dec 6; Grech, et al