# Whole brain volume loss is associated with a short-term disability progression in relapse-activity free multiple sclerosis

## TL;DR

Brain volume loss over one year is linked to disability progression in multiple sclerosis patients who are not having relapses or new brain lesions.

## Contribution

This study confirms brain volume loss as a reliable biomarker for disability progression in MS patients without relapse activity.

## Key findings

- Brain volume loss (BVL) over one year is significantly associated with EDSS progression in MS patients.
- The association holds even in patients without new T2-lesions or relapses.
- A decline in BVL from -0.5% to -1.0% increases the risk of disability progression by 26%.

## Abstract

Reliable biomarkers for disability progression independent of relapse activity (PIRA) in multiple sclerosis (MS) applicable in routine patient care are urgently needed. This study reports results from an ongoing multicenter, prospective, observational study with the primary objective of investigating the association of change in brain MRI biomarkers and PIRA.

In total 453 active relapsing remitting patients from 19 sites with baseline (BL) and one-year follow-up (FU) visits were included. At each visit, medication, relapse activity, and EDSS were recorded. MRI included 3D-T1 and 2D/3D-FLAIR. BL and FU scans enabled extraction of new/enlarged T2-lesions and brain volume loss (BVL) (annualized). Correlations and logistic regression assessed associations between EDSS progression and BVL/year.

At BL an EDSS (25%/50%/75%) of 1.5/2.0/2.5 and a time since first MS diagnosis of 2.1/5.7/11.4 years were observed. Change (FU-BL): ΔEDSS was 0.0/0.0/0.0, BVL/year was \documentclass[12pt]{minimal}
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BVL over one year was significantly associated with EDSS progression in the absence of relapses or new lesions, confirming its value as a short-term risk marker for disability progression in MS.