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T2 lesions and rate of progression of disability in multiple sclerosis
J P Mostert1, M W Koch, C Steen
1Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. j.p.mostert@neuro.umcg.nl
Background And Purpose:
To assess the predictive value of T2 lesions on the rate of progression of disability in multiple sclerosis (MS).
Methods:
We reanalyzed T2 lesion number and load on brain MRI scans, performed before 1997, of 186 MS patients, who were clinically followed. There were 90 patients with progressive MS (35 secondary progressive and 55 primary progressive), and 96 with relapsing remitting MS. The rate of progression of disability was measured by time to sustained progression of disability (defined as an increase in ≥ 1 point when the Expanded Disability Status Scale (EDSS) was 5.5 or less and an increase in EDSS of ≥ 0.5 point when the EDSS was 6.0 or higher), and by the Multiple Sclerosis Severity Score (MSSS).
Results:
During follow-up (median 15 years, IQR 12-17 years), 94% of the patients with progressive MS and 50% of the patients with relapsing remitting MS had progression of disability. Higher T2 lesion number and load were modestly associated with a higher rate of disease progression on the MSSS and a shorter time to progression of disability in relapsing remitting MS, but not in progressive MS.
Conclusions:
Our findings indicate that the amount of T2 lesions has a small predictive value for progression of disability in relapsing remitting MS, but has no influence on the rate of progression in progressive MS.
Insights
The number and load of T2 lesions on MRI scans have a small predictive value for disability progression in relapsing remitting multiple sclerosis (MS), but do not influence progression in progressive MS.
Area of Science:
- Neuroimaging
- Neurology
- Clinical Research
Background:
- Multiple sclerosis (MS) is a chronic neurological disease.
- Assessing predictors of disease progression is crucial for patient management.
- T2 lesions on MRI are a common imaging marker in MS.
Purpose of the Study:
- To evaluate the predictive capability of T2 lesion burden for disability progression in MS patients.
- To differentiate the predictive value of T2 lesions between relapsing-remitting and progressive MS subtypes.
Main Methods:
- Reanalysis of pre-1997 brain MRI scans from 186 MS patients.
- Quantification of T2 lesion number and load.
- Assessment of disability progression using time to sustained disability increase and Multiple Sclerosis Severity Score (MSSS).
Main Results:
- Higher T2 lesion number/load showed a modest association with faster disability progression (MSSS, time to progression) in relapsing-remitting MS.
- No significant association was found between T2 lesion burden and disability progression in progressive MS.
- Significant disability progression occurred in 94% of progressive MS and 50% of relapsing-remitting MS patients during a median 15-year follow-up.
Conclusions:
- T2 lesion burden offers limited predictive value for disability progression in relapsing-remitting MS.
- T2 lesion burden does not appear to influence the rate of disability progression in progressive MS.
- Further research may explore other biomarkers for predicting MS progression.
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