Long-term disability progression in primary progressive multiple sclerosis: a 15-year study

Maria A. Rocca, Maria Pia Sormani, Marco Rovaris, Domenico Caputo, Angelo Ghezzi, Enrico Montanari, Antonio Bertolotto, Alice Laroni, Roberto Bergamaschi, Vittorio Martinelli, Giancarlo Comi, Massimo Filippi

Research output: Contribution to journalArticlepeer-review


Prognostic markers of primary progressive multiple sclerosis evolution are needed. We investigated the added value of magnetic resonance imaging measures of brain and cervical cord damage in predicting long-term clinical worsening of primary progressive multiple sclerosis compared to simple clinical assessment. In 54 patients, conventional and diffusion tensor brain scans and cervical cord T1-weighted scans were acquired at baseline and after 15 months. Clinical evaluation was performed after 5 and 15 years in 49 patients. Lesion load, brain and cord atrophy, mean diffusivity and fractional anisotropy values from the brain normal-appearing white matter and grey matter were obtained. Using linear regression models, we screened the clinical and imaging variables as independent predictors of 15-year disability change (measured on the expanded disability status scale). At 15 years, 90% of the patients had disability progression. Integrating clinical and imaging variables at 15 months predicted disability changes at 15 years better than clinical factors at 5 years (R2 = 61% versus R2 = 57%). The model predicted long-term disability change with a precision within one point in 38 of 49 patients (77.6%). Integration of clinical and imaging measures allows identification of primary progressive multiple sclerosis patients at risk of long-term disease progression 4 years earlier than when using clinical assessment alone.

Original languageEnglish
Pages (from-to)2814-2819
Number of pages6
JournalBrain : a journal of neurology
Issue number11
Publication statusPublished - Nov 1 2017


  • disability
  • long-term
  • magnetic resonance imaging
  • primary progressive multiple sclerosis

ASJC Scopus subject areas

  • Clinical Neurology

Fingerprint Dive into the research topics of 'Long-term disability progression in primary progressive multiple sclerosis: a 15-year study'. Together they form a unique fingerprint.

Cite this