%A Yousuf,Fawad %A Kim,Gloria %A Tauhid,Shahamat %A Glanz,Bonnie I. %A Chu,Renxin %A Tummala,Subhash %A Healy,Brian C. %A Bakshi,Rohit %D 2016 %J Frontiers in Neurology %C %F %G English %K Brain,cortical lesions,Multiple Sclerosis,Cognition,brain atrophy,MRI,physical disability,Spinal Cord %Q %R 10.3389/fneur.2016.00099 %W %L %M %P %7 %8 2016-June-29 %9 Original Research %+ Rohit Bakshi,Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School,USA,rbakshi@post.harvard.edu %+ Rohit Bakshi,Laboratory for Neuroimaging Research, Brigham and Women’s Hospital, Harvard Medical School,USA,rbakshi@post.harvard.edu %+ Rohit Bakshi,Partners Multiple Sclerosis Center, Brigham and Women’s Hospital, Harvard Medical School,USA,rbakshi@post.harvard.edu %+ Rohit Bakshi,Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School,USA,rbakshi@post.harvard.edu %# %! Cortical lesions in MS %* %< %T The Contribution of Cortical Lesions to a Composite MRI Scale of Disease Severity in Multiple Sclerosis %U https://www.frontiersin.org/articles/10.3389/fneur.2016.00099 %V 7 %0 JOURNAL ARTICLE %@ 1664-2295 %X ObjectiveTo test a new version of the Magnetic Resonance Disease Severity Scale (v.3 = MRDSS3) for multiple sclerosis (MS), incorporating cortical gray matter lesions (CLs) from 3T magnetic resonance imaging (MRI).BackgroundMRDSS1 was a cerebral MRI-defined composite scale of MS disease severity combining T2 lesion volume (T2LV), the ratio of T1 to T2LV (T1/T2), and whole brain atrophy [brain parenchymal fraction (BPF)]. MRDSS2 expanded the scale to include cerebral gray matter fraction (GMF) and upper cervical spinal cord area (UCCA). We tested the contribution of CLs to the scale (MRDSS3) in modeling the MRI relationship to clinical status.MethodsWe studied 51 patients [3 clinically isolated syndrome, 43 relapsing-remitting, 5 progressive forms, age (mean ± SD) 40.7 ± 9.1 years, Expanded Disability Status Scale (EDSS) score 1.6 ± 1.7] and 20 normal controls by high-resolution cerebrospinal MRI. CLs required visibility on both fluid-attenuated inversion-recovery (FLAIR) and modified driven equilibrium Fourier transform sequences. The MACFIMS battery defined cognitively impaired (n = 18) vs. preserved (n = 33) MS subgroups.ResultsEDSS significantly correlated with only BPF, UCCA, MRDSS2, and MRDSS3 (all p < 0.05). After adjusting for depressive symptoms, the cognitively impaired group had higher severity of MRI metrics than the cognitively preserved group in regard to only BPF, GMF, T1/T2, MRDSS1, and MRDSS2 (all p < 0.05). CL number was not significantly related to EDSS score or cognition status.ConclusionCLs from 3T MRI did not appear to improve the validity of the MRDSS. Further studies employing advanced sequences or higher field strengths may show more utility for the incorporation of CLs into composite scales.