{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T07:26:47Z","timestamp":1772782007695,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,4,20]],"date-time":"2019-04-20T00:00:00Z","timestamp":1555718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>This study aimed to assess the predictive value of multimodal brain magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>) on survival in a large cohort of patients with motor neuron disease (<jats:styled-content style=\"fixed-case\">MND<\/jats:styled-content>), in combination with clinical and cognitive features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two hundred <jats:styled-content style=\"fixed-case\">MND<\/jats:styled-content> patients were followed up prospectively for a median of 4.13\u00a0years. At baseline, subjects underwent neurological examination, cognitive assessment and brain <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>. Grey matter volumes of cortical and subcortical structures and diffusion tensor <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> metrics of white matter tracts were obtained. A multivariable Royston\u2013Parmar survival model was created using clinical and cognitive variables. The increase of survival prediction accuracy provided by <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> variables was assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The multivariable clinical model included predominant upper or lower motor neuron presentations and diagnostic delay as significant prognostic predictors, reaching an area under the receiver operating characteristic curve (<jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>) of a 4\u2010year survival prediction of 0.79. The combined clinical and <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> model including selected grey matter fronto\u2010temporal volumes and diffusion tensor <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> metrics of the corticospinal and extra\u2010motor tracts reached an <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> of 0.89. Considering amyotrophic lateral sclerosis patients only, the clinical model including diagnostic delay and semantic fluency scores provided an <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> of 0.62, whereas the combined clinical and <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> model reached an <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> of 0.77.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study demonstrated that brain <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> measures of motor and extra\u2010motor structural damage, when combined with clinical and cognitive features, are useful predictors of survival in patients with <jats:styled-content style=\"fixed-case\">MND<\/jats:styled-content>, particularly when a diagnosis of amyotrophic lateral sclerosis is made.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.13957","type":"journal-article","created":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T13:39:56Z","timestamp":1553780396000},"page":"1143-1152","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Survival prediction models in motor neuron disease"],"prefix":"10.1111","volume":"26","author":[{"given":"F.","family":"Agosta","sequence":"first","affiliation":[{"name":"Neuroimaging Research Unit Institute of Experimental Neurology Division of Neuroscience San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. 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