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dc.contributor.authorHealy, Brian C.en_US
dc.contributor.authorBuckle, Guy J.en_US
dc.contributor.authorAli, Eman N.en_US
dc.contributor.authorEgorova, Svetlanaen_US
dc.contributor.authorKhalid, Farihaen_US
dc.contributor.authorTauhid, Shahamaten_US
dc.contributor.authorGlanz, Bonnie I.en_US
dc.contributor.authorChitnis, Tanujaen_US
dc.contributor.authorGuttmann, Charles R.G.en_US
dc.contributor.authorWeiner, Howard L.en_US
dc.contributor.authorBakshi, Rohiten_US
dc.date.accessioned2017-12-06T05:55:20Z
dc.date.issued2017en_US
dc.identifier.citationHealy, B. C., G. J. Buckle, E. N. Ali, S. Egorova, F. Khalid, S. Tauhid, B. I. Glanz, et al. 2017. “Characterizing Clinical and MRI Dissociation in Patients with Multiple Sclerosis.” Journal of Neuroimaging 27 (5): 481-485. doi:10.1111/jon.12433. http://dx.doi.org/10.1111/jon.12433.en
dc.identifier.issnen
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:34492404
dc.description.abstractABSTRACT BACKGROUND AND PURPOSE Two common approaches for measuring disease severity in multiple sclerosis (MS) are the clinical exam and brain magnetic resonance imaging (MRI) scan. Although most patients show similar disease severity on both measures, some patients have clinical/MRI dissociation. METHODS Subjects from a comprehensive care MS center who had a concurrent brain MRI, spinal cord MRI, clinical examination, and patient reported outcomes were classified into three groups based on the Expanded Disability Status Scale (EDSS) and cerebral T2 hyperintense lesion volume (T2LV). The first group was the low lesion load/high disability group (LL/HD) with T2LV < 2 ml and EDSS ≥ 3. The second group was the high lesion load/low disability group (HL/LD) with T2LV > 6 ml and EDSS ≤ 1.5. All remaining subjects were classified as not dissociated. The three groups were compared using regression techniques for unadjusted analyses and to adjust for age, disease duration, and gender. RESULTS Twenty‐two subjects were classified as LL/HD (4.1%; 95% CI: 2.6%, 6.2%), and 50 subjects were classified as HL/LD (9.4%; 95% CI: 7.0%, 12.2%). Subjects in the LL/HD group were more likely to have a progressive form of MS and had significantly lower physical quality of life in adjusted and unadjusted analysis. Subjects in HL/LD had significantly more gadolinium‐enhancing lesions, and subjects in the LL/HD group had significantly more cervical spinal cord lesions. CONCLUSIONS Our results indicate that dissociation may occur between physical disability and cerebral lesion volume in either direction in patients with MS. Type of MS, brain atrophy, and spinal cord lesions may help to bridge this dissociation.en
dc.language.isoen_USen
dc.publisherJohn Wiley and Sons Inc.en
dc.relation.isversionofdoi:10.1111/jon.12433en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC5600109/pdf/en
dash.licenseLAAen_US
dc.subjectClinical Investigative Studyen
dc.subjectclinical/MRI dissociationen
dc.subjectlesion volumeen
dc.subjectbrain atrophyen
dc.subjectquality of lifeen
dc.subjectgadolinium‐enhancing lesionsen
dc.subjectspinal cord lesionsen
dc.subjectmultiple sclerosisen
dc.titleCharacterizing Clinical and MRI Dissociation in Patients with Multiple Sclerosisen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalJournal of Neuroimagingen
dash.depositing.authorHealy, Brian C.en_US
dc.date.available2017-12-06T05:55:20Z
dc.identifier.doi10.1111/jon.12433*
dash.authorsorderedfalse
dash.contributor.affiliatedChitnis, Tanuja
dash.contributor.affiliatedGlanz, Bonnie
dash.contributor.affiliatedHealy, Brian
dash.contributor.affiliatedWeiner, Howard
dash.contributor.affiliatedBakshi, Rohit


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