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One year follow up study of primary and transitional progressive multiple sclerosis
V L Stevenson1, D H Miller, S M Leary
1NMR Research Unit, Institute of Neurology, Queen Square, London WC1 N3BG, UK.
Journal of Neurology, Neurosurgery, and Psychiatry
|May 16, 2000
Summary
This study tracked primary and transitional progressive multiple sclerosis (PP MS and TP MS) patients for one year, finding measurable changes in brain lesions and atrophy. These MRI findings may help monitor disease progression and design future treatment trials.
Area of Science:
- Neurology
- Radiology
- Neuroimmunology
Background:
- Primary and transitional progressive multiple sclerosis (PP MS and TP MS) patients exhibit subtle lesion changes despite accumulating disability.
- Serial evaluation is crucial to understand disease progression and identify reliable clinical and MRI monitoring tools for treatment trials.
Purpose of the Study:
- To document clinical and MRI characteristics of PP MS and TP MS patients over a one-year period.
- To identify potential MRI markers for monitoring disease progression in these patient groups.
Main Methods:
- 167 patients with PP MS or TP MS were recruited from six European centers.
- Patients underwent two Expanded Disability Status Scale (EDSS) assessments and brain/spinal cord MRI scans, one year apart.
Main Results:
- 25% of patients showed a one-step increase in EDSS.
- Both PP MS and TP MS groups demonstrated significant changes in T2 lesion load over one year.
- PP MS patients showed significant changes in T1 lesion load and brain atrophy, while both groups exhibited decreased cord cross-sectional area.
Conclusions:
- Despite challenges in monitoring disease progression in PP MS and TP MS, significant changes in lesion load and atrophy were observed.
- These MRI-derived changes, if correlated with long-term clinical outcomes, can aid in designing future therapeutic trials for progressive multiple sclerosis.