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A Longitudinal Study of Abnormalities on MRI and Disability from Multiple Sclerosis

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Brex, Peter A., Ciccarelli, Olga, O'Riordan, Jonathon I., Sailer, Michael, Thompson, Alan J., Miller, David H.·2002·New England Journal of Medicine

DOI 10.1056/nejmoa011341

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Abstract

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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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)
ORCID: Ciccarelli, Olga
Sailer, Michael
Thompson, Alan J.
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
DOI: 10.1056/nejmoa011341
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 › Clinical Neurology › Multiple Sclerosis Research Studies
Health Sciences › Medicine › Oncology › Polyomavirus and related diseases
Health Sciences › Medicine › Clinical 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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A Longitudinal Study of Abnormalities on MRI and Disability from Multiple Sclerosis

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