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Updated: Jun 23, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
MRI features of benign multiple sclerosis: toward a new definition of this disease phenotype
M Rovaris1, F Barkhof, M Calabrese
1Multiple Sclerosis Centre, Scientific Institute Santa Maria Nascente, Fondazione Don Gnocchi, Milan, Italy.
Abstract:
It is well known that the current classification of patients with benign multiple sclerosis (BMS), i.e., those with absent or minimal locomotor disability several years after disease onset, suffers from not having any prognostic value for the subsequent evolution of multiple sclerosis (MS). The identification of markers predictive of the longer-term course of MS will help define BMS more reliably and would allow better counseling of patients, particularly when advising on the initiation of a disease-modifying treatment. MRI-based evidence suggests that there are three potential, but not mutually exclusive, explanations for the scarce clinical impact of BMS: 1) the paucity of tissue damage within and outside MS lesions; 2) the relative sparing of clinically eloquent regions; and 3) the presence of effective compensatory mechanisms. In addition, the results of correlative MRI/neuropsychology studies underpin the need for a new definition of BMS, which should consider the maintenance of a normal cognitive profile as an additional criterion.
Insights
Benign multiple sclerosis (BMS) lacks prognostic value. New definitions incorporating MRI and cognitive function are needed for better patient counseling and treatment decisions in multiple sclerosis (MS).
Area of Science:
- Neurology
- Neuroimmunology
- Radiology
Background:
- Current classification of benign multiple sclerosis (BMS) lacks prognostic value for disease progression.
- Accurate prediction of multiple sclerosis (MS) course is crucial for patient counseling and treatment strategies.
- Existing definitions of BMS do not adequately capture long-term outcomes.
Purpose of the Study:
- To identify reliable markers for predicting the long-term course of multiple sclerosis (MS).
- To propose a refined definition of benign multiple sclerosis (BMS) incorporating prognostic indicators.
- To improve patient management and therapeutic decision-making in MS.
Main Methods:
- Utilizing magnetic resonance imaging (MRI) to assess tissue damage and lesion location.
- Analyzing MRI findings in relation to clinical disability.
- Conducting correlative MRI and neuropsychological studies.
Main Results:
- Paucity of tissue damage and relative sparing of eloquent brain regions are associated with benign multiple sclerosis (BMS).
- Effective compensatory mechanisms may contribute to the limited clinical impact in BMS.
- Normal cognitive function, assessed via neuropsychological testing, is a crucial additional criterion for defining BMS.
Conclusions:
- A new definition of benign multiple sclerosis (BMS) is warranted, integrating MRI evidence and cognitive status.
- Inclusion of cognitive performance will enhance the reliability of BMS classification.
- Improved BMS definition will facilitate personalized patient care and informed treatment choices in multiple sclerosis (MS).
