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Chronic progressive multiple sclerosis: serial magnetic resonance brain imaging over six months
R A Koopmans1, D K Li, J J Oger
1Department of Medicine, University of British Columbia, Vancouver, Canada.
Annals of Neurology
|August 1, 1989
Summary
Despite no clinical relapses in chronic progressive multiple sclerosis (MS), magnetic resonance imaging (MRI) revealed numerous active lesions. This suggests MS disease activity continues even without apparent symptoms, highlighting MRI
Area of Science:
- Neurology
- Radiology
- Immunology
Background:
- Multiple sclerosis (MS) is a chronic, progressive neurological disease.
- The transition to a chronic progressive course in MS is not fully understood.
- Clinical examination may not fully capture disease activity in MS.
Purpose of the Study:
- To prospectively evaluate disease activity in chronic progressive multiple sclerosis (MS) using serial magnetic resonance imaging (MRI).
- To compare MRI-detected activity with clinical status in progressive MS patients.
- To investigate if the disease process fundamentally changes in the chronic progressive stage of MS.
Main Methods:
- Prospective study of eight patients with chronic progressive MS over six months.
- Regular neurological examinations and head MRI scans every two weeks.
- Analysis of lesion activity (new, reappearing, or enlarging) on MRI.
Main Results:
- No clinical relapses or changes in disability ratings were observed.
- A total of 86 active MRI events were detected across 98 follow-up scans (51% showed active lesions).
- MRI-detected lesions in progressive MS were similar in appearance and pattern to those in relapsing-remitting MS, but more confluent.
Conclusions:
- Clinical inactivity in progressive MS does not equate to a lack of disease activity.
- The underlying disease process in MS may not fundamentally change between relapsing-remitting and chronic progressive stages.
- Serial MRI is significantly more sensitive than clinical examination for detecting MS disease activity.