Impact of insurance status on MRI phenotypes in MS.

Background: Health insurance in the United States varies in coverage of essential diagnostic tests, therapies, and specialists. Health disparities between privately and publicly insured patients with MS have not been comprehensively assessed. The objective of this study is to evaluate the impact of public versus private insurance on longitudinal brain outcomes in MS.
Methods: Lesional, thalamic, and gray and white matter volumes were extracted from longitudinal MRI of 710 MS patients. Baseline volumes and atrophy rates of lesional, thalamic, and gray and white matter volumes were compared across insurance groups.
Results: After image quality assessment, 376 (284 private / 92 public), 638 (499 / 139), and 331 (250 / 81), patients were in MS lesion, thalamic, gray and white matter analyses respectively. Baseline lesion volume was higher for publicly insured patients but increased at a slightly higher rate in those privately insured (p = 0.01). Baseline gray matter measurements were lower for patients with public insurance, but thalamic (p < 0.01) and gray matter (p < 0.01) atrophy rates were slightly higher in the private insurance group.
Conclusion: Insurance type was associated with lesion, thalamic, and gray matter volumes. The results suggest that patients with public insurance may present with more advanced disease.
Competing Interests: Declaration of competing interest Erica B. Baller received funding by grant K23 MH133118. The following authors have nothing to declare: Melissa Lynne Martin, Timothy Robert-Fitzgerald, Matthew K. Schindler, Christopher Perrone, Guy Schultz, Selah Lynch, Nebojsa Mirkovic, Sunil Thomas, Ameena Elahi, Donovan Reid, Tyler M. Moore, Erica Baller, Theodore D. Satterthwaite, Matthew Cieslak, Sydney Covitz, Azeez Adebimpe, Abigail Manning, Clyde E. Markowitz, John A. Detre, Amit Bar-Or, Mihir Kakara, and Russell T. Shinohara
(Copyright © 2024. Published by Elsevier B.V.)