PT - JOURNAL ARTICLE AU - R. Zivadinov AU - B. Raj AU - M. Ramanathan AU - B. Teter AU - J. Durfee AU - M.G. Dwyer AU - N. Bergsland AU - C. Kolb AU - D. Hojnacki AU - R.H. Benedict AU - B. Weinstock-Guttman TI - Autoimmune Comorbidities Are Associated with Brain Injury in Multiple Sclerosis AID - 10.3174/ajnr.A4681 DP - 2016 Jun 01 TA - American Journal of Neuroradiology PG - 1010--1016 VI - 37 IP - 6 4099 - http://www.ajnr.org/content/37/6/1010.short 4100 - http://www.ajnr.org/content/37/6/1010.full SO - Am. J. Neuroradiol.2016 Jun 01; 37 AB - BACKGROUND AND PURPOSE: The effect of comorbidities on disease severity in MS has not been extensively characterized. We determined the association of comorbidities with MR imaging disease severity outcomes in MS.MATERIALS AND METHODS: Demographic and clinical history of 9 autoimmune comorbidities confirmed by retrospective chart review and quantitative MR imaging data were obtained in 815 patients with MS. The patients were categorized on the basis of the presence/absence of total and specific comorbidities. We analyzed the MR imaging findings, adjusting for key covariates and correcting for multiple comparisons.RESULTS: Two hundred forty-one (29.6%) study subjects presented with comorbidities. Thyroid disease had the highest frequency (n = 97, 11.9%), followed by asthma (n = 41, 5%), type 2 diabetes mellitus (n = 40, 4.9%), psoriasis (n = 33, 4%), and rheumatoid arthritis (n = 22, 2.7%). Patients with MS with comorbidities showed decreased whole-brain and cortical volumes (P < .001), gray matter volume and magnetization transfer ratio of normal-appearing brain tissue (P < .01), and magnetization transfer ratio of gray matter (P < .05). Psoriasis, thyroid disease, and type 2 diabetes mellitus comorbidities were associated with decreased whole-brain, cortical, and gray matter volumes (P < .05). Psoriasis was associated with a decreased magnetization transfer ratio of normal-appearing brain tissue (P < .05), while type 2 diabetes mellitus was associated with increased mean diffusivity (P < .01).CONCLUSIONS: The presence of comorbidities in patients with MS is associated with brain injury on MR imaging. Psoriasis, thyroid disease, and type 2 diabetes mellitus comorbidities were associated with more severe nonconventional MR imaging outcomes.EDSSExpanded Disability Status ScaleLVlesion volumeMTRmagnetization transfer ratioMDmean diffusivityNABTnormal-appearing brain tissuePDproton density