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Imaging markers of multiple sclerosis prognosis
Céline Louapre1, Benedetta Bodini, Catherine Lubetzki
1aCNRS UMR 7225, ICM Institut du Cerveau et de la Moelle épinière, INSERM UMR S 1127, Hopital Pitie-Salpetriere, Paris-Sorbonne University, UPMC bDépartement de Neurologie, APHP, Hopital Pitie-Salpetriere cAPHP, Hopital Saint-Antoine, Paris, France dDepartment of Neurology, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas, USA.
Advanced imaging markers in multiple sclerosis (MS) show greater promise than conventional MRI for predicting long-term disability. These advanced metrics offer insights into microstructural damage, aiding in patient stratification for future clinical trials.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Conventional MRI markers have prognostic value in early multiple sclerosis (MS) stages.
- Advanced imaging metrics provide deeper insights into microstructural damage beyond visible lesions.
Purpose of the Study:
- To summarize recent findings on the prognostic value of imaging markers across all stages of MS.
- To highlight advanced imaging techniques for predicting long-term disability.
Main Methods:
- Review of longitudinal cohort studies in multiple sclerosis.
- Analysis of advanced quantitative MRI and PET imaging metrics.
- Evaluation of prognostic significance for disability progression.
Main Results:
- T2 lesions in clinically isolated syndrome predict conversion to definite MS (HR 5-11).
- New white matter lesions predict relapse rate and treatment response.
- Grey matter volume changes and normal-appearing tissue damage are sensitive predictors of physical and cognitive disability, particularly in progressive MS.
Conclusions:
- Advanced imaging predictors are crucial for better patient stratification in clinical trials.
- Future trials focusing on repair and neuroprotection will benefit from these advanced metrics.
- While conventional MRI is still used, advanced metrics offer superior prognostic information for long-term disability in MS.