# MRI predictors of disease and disability progression in African Americans with multiple sclerosis

> **NIH NIH R01** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2020 · $643,285

## Abstract

PROJECT SUMMARY
There is ever-growing evidence that African Americans (AAs) with multiple sclerosis (MS) present with a more
severe disease course than Caucasian-Americans (CAs) with MS. It has been reported that clinical disability
outcomes are worse, and inflammatory and MRI biomarkers significantly more unfavourable in AAs MS
patients than in their CAs counterparts. Although genetic and environmental risk factors are likely to play a
role, it is unclear why AAs MS patients experience a more disabling effect of the disease even after controlling
for education, income, and insurance status. Two previous MRI studies have suggested that the more severe
course is associated with the higher white matter (WM) lesion accumulation rather than with greater whole
brain atrophy. However, these studies were limited by the retrospective or cross-sectional design and by the
lack of assessment of regional cortical and sub-cortical gray matter (GM) volume. Moreover, potential
differences in brain GM cortical lesion (CL) count and in area/volume of the spinal cord (SC) between MS
patients of AA and CA ancestry have not been investigated up to date. Brain GM atrophy and CLs as well as
SC atrophy occur since the early stages of MS and are independent predictors of physical disability and
cognitive impairment suggesting their prominent role in determining the extent and pace of disease
progression. Therefore, we propose a prospective, longitudinal brain and cervical SC MRI study of MS patients
of AA and CA ancestry focused on the assessment of atrophy of strategic anatomical regions such as the
thalamus and SC, on the assessment of diffuse microscopic WM tissue damage in the corpus callosum and
SC and the assessment of cortical GM focal inflammation. We will also investigate the relationship between
brain and SC MRI metrics and neurological and cognitive impairment at baseline and follow-up. This research
is innovative because it proposes the first prospective clinical and MRI study of AAs MS patients with a
longitudinal design to investigate the pathophysiology of the disease in MS patients of AA ancestry and to
identify short- and medium-term predictors of disease and disability progression. The proposed research is
significant because it will advance our understanding of the pathophysiology of neurodegeneration in MS and
will provide accurate tools to better (i) understand the mechanisms leading to worse physical and cognitive
disability in AAs MS patients; (ii) identify predictors of more aggressive disease progression in MS patients of
AA descent, and (iii) help tailor therapeutic development and clinical interventions based on this knowledge.

## Key facts

- **NIH application ID:** 9987767
- **Project number:** 5R01NS100811-04
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** FRED D LUBLIN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $643,285
- **Award type:** 5
- **Project period:** 2017-09-30 → 2023-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9987767

## Citation

> US National Institutes of Health, RePORTER application 9987767, MRI predictors of disease and disability progression in African Americans with multiple sclerosis (5R01NS100811-04). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9987767. Licensed CC0.

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