Related Experiment Video
Updated: May 10, 2026
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The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
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Dynamic disability measures decrease the clinico-radiological gap in people with severely affected multiple sclerosis
Dejan Jakimovski1, Bianca Weinstock-Guttman2, Alex Burnham3
1Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
Multiple Sclerosis and Related Disorders
|April 28, 2024
Summary
The Scripps Neurological Rating Scale (SNRS) better reflects MRI changes in severely disabled multiple sclerosis patients than the Expanded Disability Status Scale (EDSS). This suggests SNRS may help bridge the gap between clinical symptoms and imaging in advanced MS.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- The Expanded Disability Status Scale (EDSS) has limitations in assessing disability in severely affected people with multiple sclerosis (pwMS).
- A need exists for more sensitive disability measures in advanced stages of multiple sclerosis (MS).
Purpose of the Study:
- To investigate the correlation between various disability assessment scales and Magnetic Resonance Imaging (MRI) outcomes in severely disabled pwMS.
- To identify which disability measures are most sensitive to underlying neuropathology in advanced MS.
Main Methods:
- PwMS from specialized facilities and an MS center were assessed using EDSS, MS Severity Scale, Scripps Neurological Rating Scale (SNRS), and Combinatorial Weight-Adjusted Disability Score (CombiWISE).
- MRI outcomes included T1 and T2 lesion volume (LV), whole brain volume (WBV), gray matter volume (GMV), medulla oblongata volume (MOV), thalamic volume (TV), and thalamic dysconnectivity.
- Statistical analyses compared disability scores and correlated them with MRI findings.
Main Results:
- Significant differences in disability were observed between patient groups, particularly in SNRS and CombiWISE scores.
- The SNRS demonstrated stronger correlations with a wider range of MRI pathology measures (8/9 outcomes) compared to EDSS (3/9 outcomes) in the combined cohort.
- In severely affected pwMS, SNRS showed associations with T1-LV, T2-LV, and WBV, while EDSS did not show significant associations with these MRI metrics.
Conclusions:
- The SNRS appears to be a more sensitive measure of disability and underlying brain pathology in severely affected pwMS than the EDSS.
- Granular and dynamic disability measures like SNRS may help bridge the clinico-radiological gap in advanced multiple sclerosis.
- Further validation of SNRS and similar scales is warranted for clinical use in severely disabled MS populations.
