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Updated: Jun 1, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Clinical consequences of MRI activity in treated multiple sclerosis
Diego Cadavid1, Soyeon Kim, Bo Peng
1Department of Neurology and Neuroscience, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, USA. cadavidi@umdnj.edu
Background:
Inflammation on brain MRI is the most sensitive marker of disease activity in multiple sclerosis (MS) but its clinical consequences remain controversial.
Objective:
Here we investigated the clinical consequences of MRI activity in MS subjects treated with two different first line disease modifying agents.
Methods:
Seventy-five treatment-naïve subjects with relapsing-remitting MS (N = 61) or clinically isolated syndromes at risk of MS (N = 14) from the BECOME study that had been randomized to interferon beta-1b (N = 39) or glatiramer acetate (N = 36) and followed for up to two years by monthly brain MRI optimized to detect inflammatory activity were studied for the clinical consequences of lack of MRI remission.
Results:
MRI remission occurred in 46.4% of participants transiently and in 23.2% completely while it was never achieved in 30.4%. There was no difference by treatment in MRI remission, progression of physical disability, or cognitive function. The percentage of relapse-free subjects was 87.5% for the group in complete MRI remission, 47.6% in the group never in remission and 59.4% in the group in transient remission (p = 0.017). Similar differences were observed for six-month-confirmed worsening of ambulatory function as measured by the timed 25 foot walk (p = 0.026) and by Expanded Disability Status Scale (EDSS) (p = 0.10). Cognitive function was lowest at baseline for the group that never reached MRI remission on treatment; this group improved the least upon repeated cognitive testing during the two years of treatment (p < 0.001).
Conclusions:
Lack of MRI remission during treatment with interferon beta-1b or glatiramer acetate is associated with higher relapse rate and worsening of physical and cognitive function.
Insights
Lack of MRI remission in multiple sclerosis (MS) patients treated with interferon beta-1b or glatiramer acetate correlates with increased relapses and worsening physical and cognitive function. Achieving MRI remission is crucial for better outcomes in MS management.
Area of Science:
- Neurology
- Neuroimmunology
- Radiology
Background:
- Brain MRI inflammation is a key marker for multiple sclerosis (MS) disease activity.
- The clinical impact of MRI activity in MS patients remains debated.
- This study examines the clinical consequences of MRI activity in MS patients on first-line disease-modifying therapies.
Purpose of the Study:
- To investigate the clinical consequences of MRI activity in MS patients treated with interferon beta-1b or glatiramer acetate.
- To assess the relationship between MRI remission and clinical outcomes, including relapses, physical disability, and cognitive function.
Main Methods:
- The BECOME study included 75 treatment-naïve MS or at-risk clinically isolated syndrome patients.
- Participants were randomized to interferon beta-1b (n=39) or glatiramer acetate (n=36).
- Monthly brain MRIs were conducted for up to two years to monitor inflammatory activity and remission.
Main Results:
- Complete MRI remission was achieved by 23.2% of participants; 46.4% had transient remission, and 30.4% never achieved remission.
- No significant differences in MRI remission rates were observed between interferon beta-1b and glatiramer acetate.
- Lack of MRI remission was associated with higher relapse rates (p=0.017), worsening ambulatory function (p=0.026), and poorer cognitive function improvement (p<0.001).
Conclusions:
- Failure to achieve MRI remission during treatment with interferon beta-1b or glatiramer acetate is linked to adverse clinical outcomes in MS.
- These findings highlight the importance of monitoring MRI activity to predict and potentially mitigate disease progression.
- Optimizing treatment strategies to achieve MRI remission may be critical for managing physical and cognitive decline in MS.
Related Concept Videos
01:19Multiple Sclerosis l: Introduction
01:24Magnetic Resonance Imaging
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01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...