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BioMed Research International
Volume 2014, Article ID 875768, 8 pages
http://dx.doi.org/10.1155/2014/875768
Clinical Study

Determinants of Disability in Multiple Sclerosis: An Immunological and MRI Study

1Unit of Motor Neurorehabilitation, Multiple Sclerosis Center, Fondazione Don Gnocchi, IRCCS Santa Maria Nascente, Via Capecelatro 66, 20148 Milan, Italy
2MR Research Laboratory, Fondazione Don Gnocchi, IRCCS Santa Maria Nascente, Via Capecelatro 66, 20148 Milan, Italy
3Immunology Research Laboratory, Fondazione Don Gnocchi, IRCCS Santa Maria Nascente, Via Capecelatro 66, 20148 Milan, Italy
4Bioengineering Department, Politecnico di Milano, Piazza Leonardo da Vinci, 20133 Milan, Italy
5Epidemiology and Statistics Unit, Fondazione Don Gnocchi, IRCCS Santa Maria Nascente, Via Capecelatro 66, 20148 Milan, Italy
6Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany

Received 17 January 2014; Revised 12 March 2014; Accepted 17 March 2014; Published 9 April 2014

Academic Editor: Cristoforo Comi

Copyright © 2014 Paola Tortorella et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Multiple sclerosis (MS) is characterized by a wide interpatient clinical variability and available biomarkers of disease severity still have suboptimal reliability. We aimed to assess immunological and MRI-derived measures of brain tissue damage in patients with different motor impairment degrees, for in vivo investigating the pathogenesis of MS-related disability. Twenty-two benign (B), 26 secondary progressive (SP), and 11 early, nondisabled relapsing-remitting (RR) MS patients and 37 healthy controls (HC) underwent conventional and diffusion tensor brain MRI and, as regards MS patients, immunophenotypic and functional analysis of stimulated peripheral blood mononuclear cells (PBMC). Corticospinal tract (CST) fractional anisotropy and grey matter volume were lower and CST diffusivity was higher in SPMS compared to RRMS and BMS patients. CD14+IL6+ and CD4+IL25+ cell percentages were higher in BMS than in SPMS patients. A multivariable model having EDSS as the dependent variable retained the following independent predictors: grey matter volume, CD14+IL6+ and CD4+IL25+ cell percentages. In patients without motor impairment after long-lasting MS, the grey matter and CST damage degree seem to remain as low as in the earlier disease stages and an immunological pattern suggestive of balanced pro- and anti-inflammatory activity is observed. MRI-derived and immunological measures might be used as complementary biomarkers of MS severity.