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Updated: Apr 14, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Magnetic resonance imaging correlates of clinical outcomes in early multiple sclerosis
Amir-Hadi Maghzi1, Nisha Revirajan1, Laura J Julian2
1Departments of Neurology, University of California San Francisco, San Francisco, CA, United States.
Objectives:
To study the association between changes in brain magnetic resonance imaging (MRI) and clinical outcomes in early MS.
Methods:
MS patients within 12 months of onset were enrolled and followed up to 3 years. Clinical measures included Symbol Digit Modalities Test (SDMT), MS Functional Composite (MSFC) and low contrast letter acuity (LCLA). MRI outcomes included brain volume changes measured by SIENA and SIENAX normalized measurements [brain parenchymal volume (BPV), normal-appearing white and gray matter volume (NAWMV and GMV) and T2 lesion volume (T2LV)]. Mixed model regression measured time trends and associations between imaging and clinical outcome.
Results:
Forty-three patients were enrolled within 7.5±4.9 months of onset. Baseline T2 lesion volume predicted subsequent changes in Paced Auditory Serial Addition Test (PASAT) (p=0.004), whereas baseline measures of atrophy including BPV, GMV, and NAWMV predicted longitudinal changes in MSFC (p=0.016, p=0.040, p=0.021, respectively) and Timed-25 Foot Walk (p<0.05). Each 1% decrease in SIENA was associated with 1.14 point decrease in SDMT score (p=0.03). Each 1% decrease in brain volume SIENA was associated with almost 1.5 letters decrease on LCLA (p=0.02).
Conclusion:
Measures of lesion volume and overall brain volume were associated with different long-term clinical outcome measures in early MS.
Insights
In early multiple sclerosis (MS), lesion volume impacts auditory processing, while brain atrophy predicts physical and composite functional outcomes over time.
Area of Science:
- Neuroimaging
- Neurology
- Clinical Research
Background:
- Early multiple sclerosis (MS) is characterized by inflammatory lesions and progressive brain atrophy.
- Understanding the relationship between these imaging markers and clinical outcomes is crucial for predicting disease progression.
Purpose of the Study:
- To investigate the association between changes in brain magnetic resonance imaging (MRI) metrics and clinical outcomes in patients with early MS.
- To determine if lesion volume and brain atrophy predict different aspects of long-term clinical decline.
Main Methods:
- Early MS patients (within 12 months of onset) were followed for up to 3 years.
- Clinical assessments included Symbol Digit Modalities Test (SDMT), MS Functional Composite (MSFC), and low contrast letter acuity (LCLA).
- Brain volume changes (brain parenchymal volume, normal-appearing white and gray matter volume, T2 lesion volume) were quantified using SIENA and SIENAX; associations were analyzed using mixed-effects models.
Main Results:
- Baseline T2 lesion volume predicted changes in Paced Auditory Serial Addition Test (PASAT) scores.
- Baseline brain atrophy measures (BPV, GMV, NAWMV) predicted changes in MSFC and Timed-25 Foot Walk.
- A 1% decrease in brain volume (SIENA) correlated with a 1.14-point decrease in SDMT and a 1.5-letter decrease in LCLA.
Conclusions:
- Lesion volume and overall brain volume changes are associated with distinct clinical outcomes in early MS.
- MRI-derived measures of lesion load and atrophy provide valuable prognostic information for different functional domains.
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