Gadolinium‐based contrast agent exposures and physical and cognitive disability in multiple sclerosis

Background and Purpose The clinical correlation of gadolinium‐based contrast agents (GBCAs) has not been well studied in multiple sclerosis (MS). We investigated the extent to which the number of GBCA administrations relates to self‐reported disability and performance measures. Methods A cohort of M...

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Veröffentlicht in:Journal of neuroimaging 2023-01, Vol.33 (1), p.85-93
Hauptverfasser: Nakamura, Kunio, McGinley, Marisa P., Jones, Stephen E., Lowe, Mark J., Cohen, Jeffrey A., Ruggieri, Paul M., Ontaneda, Daniel
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container_end_page 93
container_issue 1
container_start_page 85
container_title Journal of neuroimaging
container_volume 33
creator Nakamura, Kunio
McGinley, Marisa P.
Jones, Stephen E.
Lowe, Mark J.
Cohen, Jeffrey A.
Ruggieri, Paul M.
Ontaneda, Daniel
description Background and Purpose The clinical correlation of gadolinium‐based contrast agents (GBCAs) has not been well studied in multiple sclerosis (MS). We investigated the extent to which the number of GBCA administrations relates to self‐reported disability and performance measures. Methods A cohort of MS patients was analyzed in this retrospective observational study. The main outcome was the association between the cumulative number of GBCA exposures (linear or macrocyclic GBCA), Patient‐Determined Disease Steps (PDDS), and measures of physical and cognitive performance (walking speed test, manual dexterity test [MDT], and processing speed test [PST]). The analysis was performed first cross‐sectionally and then longitudinally. Results The cross‐sectional data included 1059 MS patients with a mean age of 44.0 years (standard deviation = 11.2). While the contrast ratio in globus pallidus weakly correlated with PDDS, MDT, and PST in a univariate correlational analysis (coefficients, 95% confidence interval [CI] = 0.11 [0.04, 0.18], 0.15 [0.08, 0.21], and –0.16 [–0.10, –0.23], respectively), the associations disappeared after covariate adjustment. A significant association was found between number of linear GBCA administrations and PDDS (coefficient [CI] = –0.131 [–0.196, –0.067]), and MDT associated with macrocyclic GBCA administrations (–0.385 [–0.616, –0.154]), but their signs indicated better outcomes in patients with greater GBCA exposures. The longitudinal data showed no significant detrimental effect of macrocyclic GBCA exposures. Conclusion No detrimental effects were observed between GBCA exposure and self‐reported disability and standardized objective measures of physical and cognitive performance. While several weak associations were found, they indicated benefit on these measures.
doi_str_mv 10.1111/jon.13057
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We investigated the extent to which the number of GBCA administrations relates to self‐reported disability and performance measures. Methods A cohort of MS patients was analyzed in this retrospective observational study. The main outcome was the association between the cumulative number of GBCA exposures (linear or macrocyclic GBCA), Patient‐Determined Disease Steps (PDDS), and measures of physical and cognitive performance (walking speed test, manual dexterity test [MDT], and processing speed test [PST]). The analysis was performed first cross‐sectionally and then longitudinally. Results The cross‐sectional data included 1059 MS patients with a mean age of 44.0 years (standard deviation = 11.2). While the contrast ratio in globus pallidus weakly correlated with PDDS, MDT, and PST in a univariate correlational analysis (coefficients, 95% confidence interval [CI] = 0.11 [0.04, 0.18], 0.15 [0.08, 0.21], and –0.16 [–0.10, –0.23], respectively), the associations disappeared after covariate adjustment. A significant association was found between number of linear GBCA administrations and PDDS (coefficient [CI] = –0.131 [–0.196, –0.067]), and MDT associated with macrocyclic GBCA administrations (–0.385 [–0.616, –0.154]), but their signs indicated better outcomes in patients with greater GBCA exposures. The longitudinal data showed no significant detrimental effect of macrocyclic GBCA exposures. Conclusion No detrimental effects were observed between GBCA exposure and self‐reported disability and standardized objective measures of physical and cognitive performance. While several weak associations were found, they indicated benefit on these measures.</description><identifier>ISSN: 1051-2284</identifier><identifier>EISSN: 1552-6569</identifier><identifier>DOI: 10.1111/jon.13057</identifier><identifier>PMID: 36181666</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Clinical Investigative Study ; Cognitive ability ; Contrast agents ; Contrast media ; Contrast Media - adverse effects ; Cross-Sectional Studies ; Exposure ; Gadolinium ; Gadolinium - adverse effects ; Gadolinium DTPA ; gadolinium‐based contrast agent ; Globus pallidus ; Humans ; magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Manual dexterity ; Multiple sclerosis ; Multiple Sclerosis - diagnostic imaging ; Neuroimaging ; Organometallic Compounds ; Original Research ; Processing Speed ; Retrospective Studies</subject><ispartof>Journal of neuroimaging, 2023-01, Vol.33 (1), p.85-93</ispartof><rights>2022 The Authors. published by Wiley Periodicals LLC on behalf of American Society of Neuroimaging.</rights><rights>2022 The Authors. Journal of Neuroimaging published by Wiley Periodicals LLC on behalf of American Society of Neuroimaging.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4437-b9b0b4cdf42e840f537b113d439d6d5cebd0f757d9e5a19df0b012c763d2b65e3</citedby><cites>FETCH-LOGICAL-c4437-b9b0b4cdf42e840f537b113d439d6d5cebd0f757d9e5a19df0b012c763d2b65e3</cites><orcidid>0000-0002-7833-8138</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjon.13057$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjon.13057$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,315,781,785,886,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36181666$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakamura, Kunio</creatorcontrib><creatorcontrib>McGinley, Marisa P.</creatorcontrib><creatorcontrib>Jones, Stephen E.</creatorcontrib><creatorcontrib>Lowe, Mark J.</creatorcontrib><creatorcontrib>Cohen, Jeffrey A.</creatorcontrib><creatorcontrib>Ruggieri, Paul M.</creatorcontrib><creatorcontrib>Ontaneda, Daniel</creatorcontrib><title>Gadolinium‐based contrast agent exposures and physical and cognitive disability in multiple sclerosis</title><title>Journal of neuroimaging</title><addtitle>J Neuroimaging</addtitle><description>Background and Purpose The clinical correlation of gadolinium‐based contrast agents (GBCAs) has not been well studied in multiple sclerosis (MS). We investigated the extent to which the number of GBCA administrations relates to self‐reported disability and performance measures. Methods A cohort of MS patients was analyzed in this retrospective observational study. The main outcome was the association between the cumulative number of GBCA exposures (linear or macrocyclic GBCA), Patient‐Determined Disease Steps (PDDS), and measures of physical and cognitive performance (walking speed test, manual dexterity test [MDT], and processing speed test [PST]). The analysis was performed first cross‐sectionally and then longitudinally. Results The cross‐sectional data included 1059 MS patients with a mean age of 44.0 years (standard deviation = 11.2). While the contrast ratio in globus pallidus weakly correlated with PDDS, MDT, and PST in a univariate correlational analysis (coefficients, 95% confidence interval [CI] = 0.11 [0.04, 0.18], 0.15 [0.08, 0.21], and –0.16 [–0.10, –0.23], respectively), the associations disappeared after covariate adjustment. A significant association was found between number of linear GBCA administrations and PDDS (coefficient [CI] = –0.131 [–0.196, –0.067]), and MDT associated with macrocyclic GBCA administrations (–0.385 [–0.616, –0.154]), but their signs indicated better outcomes in patients with greater GBCA exposures. The longitudinal data showed no significant detrimental effect of macrocyclic GBCA exposures. Conclusion No detrimental effects were observed between GBCA exposure and self‐reported disability and standardized objective measures of physical and cognitive performance. 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We investigated the extent to which the number of GBCA administrations relates to self‐reported disability and performance measures. Methods A cohort of MS patients was analyzed in this retrospective observational study. The main outcome was the association between the cumulative number of GBCA exposures (linear or macrocyclic GBCA), Patient‐Determined Disease Steps (PDDS), and measures of physical and cognitive performance (walking speed test, manual dexterity test [MDT], and processing speed test [PST]). The analysis was performed first cross‐sectionally and then longitudinally. Results The cross‐sectional data included 1059 MS patients with a mean age of 44.0 years (standard deviation = 11.2). While the contrast ratio in globus pallidus weakly correlated with PDDS, MDT, and PST in a univariate correlational analysis (coefficients, 95% confidence interval [CI] = 0.11 [0.04, 0.18], 0.15 [0.08, 0.21], and –0.16 [–0.10, –0.23], respectively), the associations disappeared after covariate adjustment. A significant association was found between number of linear GBCA administrations and PDDS (coefficient [CI] = –0.131 [–0.196, –0.067]), and MDT associated with macrocyclic GBCA administrations (–0.385 [–0.616, –0.154]), but their signs indicated better outcomes in patients with greater GBCA exposures. The longitudinal data showed no significant detrimental effect of macrocyclic GBCA exposures. Conclusion No detrimental effects were observed between GBCA exposure and self‐reported disability and standardized objective measures of physical and cognitive performance. 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subjects Adult
Clinical Investigative Study
Cognitive ability
Contrast agents
Contrast media
Contrast Media - adverse effects
Cross-Sectional Studies
Exposure
Gadolinium
Gadolinium - adverse effects
Gadolinium DTPA
gadolinium‐based contrast agent
Globus pallidus
Humans
magnetic resonance imaging
Magnetic Resonance Imaging - methods
Manual dexterity
Multiple sclerosis
Multiple Sclerosis - diagnostic imaging
Neuroimaging
Organometallic Compounds
Original Research
Processing Speed
Retrospective Studies
title Gadolinium‐based contrast agent exposures and physical and cognitive disability in multiple sclerosis
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