PREDICTING THE COURSE OF MULTIPLE SCLEROSIS BASED ON THE CLINIC AND MRI-MORPHOMETRY

Aim: Comparative analysis of the clinical and morphometric predictions of the course of multiple sclerosis (MS) depending on the duration of the disease and the clinical form. Material and methods: 20 patients diagnosed with MS and observational period of at least 5 years were included in the study. The disease duration ranged from 1 to 22 years, the number of visits from 3 to 9. All patients underwent MRI investigation to confirm the diagnosis. Regression analysis using clinical and morphometric parameters with a prognostic significance of more than 0.5 were used to prognose the course of the disease. Clinical parameters included the duration of the disease (in years), the level of EDSS (in points) and the type of MS disease course. 10 morphometric parameters describing the lateral ventricles and the cerebral parenchyma were also used. Results: Analysis of clinical and morphometric prognostic parameters depending on the duration of the disease revealed statistically significant differences in patient groups with 1 year, 6-10 years and more than 10 years disease duration. Group analysis depending on the clinical form of the disease showed similar patterns: the Morphometric prognosis significantly precedes over clinical prognosis during disease debut, and on the contrary, in secondary progredient course of MS, the clinical prognosis precedes that of MRI. Relapsing form of MS did not reveal statistically significant differences in terms of prognosis. Conclusion: In early stages of MS, atrophic changes in brain matter are observed, which correlate with the severity of the disease course. Calculation of the prognostic indicators in patients allows estimating the type of disease course, and in patients with a remitting MS - to predict progression and transition to secondary-progredient form. Complex dynamic assessment of the clinical and morphometric prognosis can be used to clarify the type of disease course as well as therapy correction.