Related Experiment Videos
Quantitative brain MRI lesion load predicts the course of clinically isolated syndromes suggestive of multiple
M Filippi1, M A Horsfield, S P Morrissey
1NMR Research Group, Institute of Neurology, London, UK.
Abstract:
We performed semiautomated quantitative measurement of brain magnetic resonance imaging (MRI) abnormalities seen at presentation and at 5-year follow-up in 84 patients presenting with an acute clinically isolated syndrome of the optic nerves, brainstem, or spinal cord suggestive of multiple sclerosis (MS). At follow-up, 34 (40%) had developed clinically definite and four (5%) clinically probable MS. Patients who developed MS during follow-up had a higher lesion load at presentation than those who did not. There was a strong correlation of the MRI lesion load at presentation with both the increase in lesion load over the next 5 years and disability at follow-up. Increasing initial lesion load correlated with a decreasing time to development of MS clinically (r = -0.328, p < 0.05). At follow-up, disability and brain lesion load were strongly correlated in patients who had developed MS. These results establish that MRI at presentation with clinically isolated syndromes suggestive of MS is useful in predicting the subsequent clinical course and the development of new MRI lesions. This suggests that quantitative brain MRI will be helpful in selecting patients with early clinical MS for treatment trials and for subsequent monitoring of their response to treatment.
Insights
Brain magnetic resonance imaging (MRI) in clinically isolated syndromes can predict multiple sclerosis (MS) development. Higher initial lesion load on MRI correlates with faster MS progression and future disability.
Area of Science:
- Neuroimaging
- Neurology
- Clinical Medicine
Background:
- Clinically isolated syndromes (CIS) are initial presentations suggestive of multiple sclerosis (MS).
- Predicting the conversion of CIS to MS and subsequent disability is crucial for patient management.
- Quantitative MRI offers a potential tool for early prediction.
Purpose of the Study:
- To assess the utility of quantitative brain MRI at presentation of CIS in predicting the development of MS.
- To evaluate the correlation between initial MRI lesion load and disease progression over 5 years.
- To determine if MRI findings can predict future disability in patients with CIS.
Main Methods:
- Semiautomated quantitative measurement of brain MRI abnormalities in 84 patients with CIS.
- Follow-up assessment at 5 years for clinical diagnosis of MS and disability.
- Correlation analysis between initial MRI lesion load, lesion progression, time to MS diagnosis, and disability.
Main Results:
- 40% of patients developed clinically definite MS and 5% probable MS within 5 years.
- Patients who developed MS had a higher initial brain MRI lesion load.
- Initial lesion load strongly correlated with lesion increase over 5 years, time to MS diagnosis, and follow-up disability.
Conclusions:
- Quantitative brain MRI at the time of CIS presentation is a valuable tool for predicting clinical course and MS development.
- MRI findings can help identify patients at higher risk of progression and disability.
- This approach may aid in selecting early MS patients for treatment trials and monitoring therapeutic response.