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Predictors of short-term, relapse-independent progression in multiple sclerosis: A machine learning approach based on clinical data and conventional MRI-derived features

Title: Predictors of short-term, relapse-independent progression in multiple sclerosis: A machine learning approach based on clinical data and conventional MRI-derived features
Authors: Ianniello A.; Barbuti E.; Capobianco M. F.; Tranfa M.; Miele C.; Ruggieri S.; Pontillo G.; Cocozza S.; Pantano P.; Pozzilli C.; Cuocolo R.; Petracca M.
Contributors: Ianniello, A.; Barbuti, E.; Capobianco, M. F.; Tranfa, M.; Miele, C.; Ruggieri, S.; Pontillo, G.; Cocozza, S.; Pantano, P.; Pozzilli, C.; Cuocolo, R.; Petracca, M.
Publication Year: 2026
Subject Terms: Brain atrophy; Conventional MRI biomarker; Machine learning; Multiple sclerosi; Progression independent of relapse activity; Spinal cord atrophy
Description: Background: Progression independent of relapse activity (PIRA) contributes to long-term disability in multiple sclerosis (MS), even in early stages. However, predicting short-term PIRA in routine clinical settings remains a challenge. Objectives: To develop and evaluate machine learning (ML) models to predict PIRA in relapsing MS using routinely available clinical and conventional MRI-derived features. Methods: We developed two ML models to predict PIRA at 24 and 36 months in relapsing MS using baseline and longitudinal clinical and conventional MRI-derived data including brain and spine lesion burden, atrophy, and change in structural connectivity (ChaCo) scores. A Naïve Bayes classifier was trained after feature selection and class balancing with Synthetic Minority Over-sampling Technique (SMOTE). Results: Among 186 patients, 12.4% experienced PIRA at 24 months. In a longitudinal subset (n = 81), 19.7% developed PIRA at 36 months. The 24-month model, achieved moderate discriminative performance (AUC = 0.73), mainly driven by baseline features. The 36-month model, including baseline disability, brain volume and volume change over time, new cervical cord lesions and baseline ChaCo features, showed improved accuracy (AUC = 0.83). Conclusions: ML models using clinical and conventional MRI features can predict short-term PIRA with moderate-to-high accuracy. Incorporating imaging changes over time enhances prediction and may support earlier individualized treatment strategies.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/41780422; info:eu-repo/semantics/altIdentifier/wos/WOS:001709956500001; volume:483; firstpage:1; lastpage:6; numberofpages:6; journal:JOURNAL OF THE NEUROLOGICAL SCIENCES; https://hdl.handle.net/11386/4939163
DOI: 10.1016/j.jns.2026.125846
Availability: https://hdl.handle.net/11386/4939163; https://doi.org/10.1016/j.jns.2026.125846
Accession Number: edsbas.360F9B85
Database: BASE