A longitudinal study of abnormalities on MRI and disability from multiple sclerosis
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Background In patients with isolated syndromes that are clinically suggestive of multiple sclerosis, such as optic neuritis or brain-stem or spinal cord syndromes, the presence of lesions as determined by T2-weighted magnetic resonance imaging (MRI) of the brain increases the likelihood that multiple sclerosis will develop. We sought to determine the relation between early lesion volume, changes in volume, and long-term disability. Methods Seventy-one patients in a serial MRI study of patients with isolated syndromes were reassessed after a mean of 14.1 years. Disability was measured with the use of Kurtzke's Expanded Disability Status Scale (EDSS; possible range, 0 to 10, with a higher score indicating a greater degree of disability). Results Clinically definite multiple sclerosis developed in 44 of the 50 patients (88 percent) with abnormal results on MRI at presentation and in 4 of 21 patients (19 percent) with normal results on MRI. The median EDSS score at follow-up for those with multiple sclerosis was 3.25 (range, 0 to 10); 31 percent had an EDSS score of 6 or more (including three patients whose deaths were due to multiple sclerosis). The EDSS score at 14 years correlated moderately with lesion volume on MRI at 5 years (r=0.60) and with the increase in lesion volume over the first 5 years (r=0.61). Conclusions In patients who first present with isolated syndromes suggestive of multiple sclerosis, the increases in the volume of the lesions seen on magnetic resonance im…
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Conventional T2-weighted MRI (cMRI) largely fails to predict the degree of patients' disability.
“Conventional T2-weighted MRI (cMRI) largely fails to predict the degree of patients' disability.”
From Diffusion tensor imaging of post mortem multiple sclerosis brain (2007) · cites this paper as Brex et al., 2002
The inability of cMRI to reflect MS pathology in more detail may be one of the major reasons why the correlation between cMRI measures and disability is only modest.
“The inability of cMRI to reflect MS pathology in more detail may be one of the major reasons why the correlation between cMRI measures and disability is only modest (Kappos et al., 1999; Brex et al., 2002).”
From Diffusion tensor imaging of post mortem multiple sclerosis brain (2007) · cites this paper as Brex et al., 2002
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- Authors
- Brex, P. A., Ciccarelli, O., O'Riordan, J. I., Sailer, M., Thompson, A. J., & Miller, D. H.
- Affiliations
- National Hospital for Neurology and Neurosurgery (GB)
- Otto-von-Guericke-Universität Magdeburg (DE)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2002-01-17
- Volume
- 346
- Issue
- 3
- Pages
- 158-164
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W1966515383
- Cited by
- 861
- References
- 42
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 11 · 2023: 9 · 2022: 14 · 2021: 20 · 2020: 14 · 2019: 23 · 2018: 27 · 2017: 33 · 2016: 30 · 2015: 32 · 2014: 44 · 2013: 34 · 2012: 40
- FWCI
- 36.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Multiple Sclerosis Society
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Oncology › Polyomavirus and related diseases
- Health Sciences › Medicine › Neurology › Peripheral Neuropathies and Disorders
- Keywords
- multiple sclerosis, long-term disability, Expanded Disability Status Scale, optic neuritis, spinal cord syndromes, T2-weighted MRI, disease-modifying therapy, disease progression
- MeSH terms
- Adolescent, Adult, Brain, Brain Diseases, Brain Stem, Disability Evaluation, Female, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Male, Middle Aged, Multiple Sclerosis, Optic Neuritis, Spinal Cord Diseases
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