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The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
A longitudinal study of abnormalities on MRI and disability from multiple sclerosis
Peter A Brex1, Olga Ciccarelli, Jonathon I O'Riordan
1Nuclear Magnetic Resonance Research Unit, Institute of Neurology, Queen Sq., London, United Kingdom.
The New England Journal of Medicine
|January 18, 2002
Summary
Early brain lesion volume on MRI in patients with suspected multiple sclerosis predicts long-term disability. Increased lesion volume in the first five years correlates with greater disability, aiding in prognosis.
Area of Science:
- Neurology
- Radiology
- Clinical Medicine
Background:
- T2-weighted MRI brain lesions in patients with isolated syndromes suggestive of multiple sclerosis (MS) increase the likelihood of developing MS.
- Early identification of prognostic factors is crucial for managing MS progression.
Purpose of the Study:
- To determine the relationship between early lesion volume, changes in lesion volume, and long-term disability in patients presenting with isolated syndromes suggestive of MS.
Main Methods:
- A serial MRI study reassessed 71 patients with isolated syndromes after a mean of 14.1 years.
- Disability was measured using Kurtzke's Expanded Disability Status Scale (EDSS).
Main Results:
- 88% of patients with abnormal MRI at presentation developed clinically definite MS, versus 19% with normal MRI.
- EDSS scores at 14 years moderately correlated with lesion volume at 5 years (r=0.60) and lesion volume increase (r=0.61).
- 31% of MS patients had an EDSS score of 6 or more at follow-up.
Conclusions:
- Increases in brain lesion volume within the first five years correlate with long-term disability in patients with initial isolated syndromes suggestive of MS.
- Leison volume alone is a moderate predictor and may not be sufficient for treatment decisions regarding disease-modifying therapies.
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