Early MRI in optic neuritis: the risk for clinically definite multiple sclerosis

Area of Science:

• Neuroimaging
• Neurology
• Multiple Sclerosis Research

Background:

• MRI brain lesions in optic neuritis (ON) indicate a higher risk for developing clinically definite multiple sclerosis (CDMS).
• Detailed early MRI findings can potentially improve the prediction of conversion to CDMS.

Purpose of the Study:

• To investigate how lesion characteristics (number, location, activity) at presentation, early follow-up MRI findings, and non-lesion MRI measures influence conversion from ON to CDMS.

Main Methods:

• Prospective study of 142 ON patients with serial MRI and clinical follow-up.
• Cox regression analysis used to identify independent early MRI predictors of time to CDMS.
• Evaluated baseline and 3-month MRI measures, including lesion activity, brain atrophy, magnetization transfer ratio, and spectroscopy.

Main Results:

• 80% of patients had abnormal baseline MRI; 40% converted to CDMS within a median of 16 months.
• Baseline predictors included gender, periventricular, and gadolinium-enhancing lesions.
• New T2 lesions on early follow-up MRI were the strongest independent predictor of CDMS (HR 4.9).

Conclusions:

• New T2 lesions identified on early follow-up MRI scans are the most significant independent predictor for CDMS conversion in ON patients.
• Baseline periventricular lesions and gender also independently predict CDMS.
• Non-conventional MRI measures did not predict CDMS in this cohort.