Differentiating Severe Multiple Sclerosis Through a Comprehensive Assessment: Robert Zivadinov, MD, PhD


The director of the Buffalo Neuroimaging Analysis Center provided context on the CASA-MS study, and the key differences in why certain patients with multiple sclerosis experience more rapid disability progression. [WATCH TIME: 4 minutes]

WATCH TIME: 4 minutes

"Lesions, which are the usual suspects of disability progression and a major target of treatment for disease-modifying therapies, was not at all different between the 2 groups. It was the whole brain volume, which includes total amount of brain atrophy."

While there have been advances in the treatment of relapsing forms of multiple sclerosis (MS), understanding why some patients continue to progress at rapid rates remains a critical unmet need. A progressive disease course—either primary progressive MS at onset or transitioning to secondary progressive MS—is the dominant factor affecting MS-related neurologic disability accumulation.

The Comprehensive Assessment of Severely Affected Multiple Sclerosis (CASA-MS) study, a collaborative effort between The Boston Home (TBH) and the University at Buffalo (UB), aimed to fully characterize and define severe MS through imaging, clinical, cognitive, and laboratory features of this disease subtype. Inclusion criteria between the 2 centers differed, as patients residing in TBH had Expanded Disability Status scores between 8.0 and 9.5, while those at UB had scores between 3.0 and 6.5.

Lead investigator Robert Zivadinov, MD, PhD, director of the Buffalo Neuroimaging Analysis Center, presented the initial findings from the study at the 2023 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum, held February 23-25, in San Diego, California. At the meeting, he sat down with NeurologyLive® to discuss some of the major take-home points from the research, and the differences in severely affected MS. Specifically, he spoke about the severe gray matter loss observed in the cortex and thalamus, as well as why brain lesion burden in the white matter was not a significant driver of disability.

Click here for more 2023 ACTRIMS Forum content.

1. Zivadinov R, Jakimovski D, Burnham A, et al. Comprehensive assessment of severely affected multiple sclerosis (CASA-MS) study. Presented at: 2023 ACTRIMS Forum; February 23-25. San Diego, CA. Abstract P430
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