Disability and T2 MRI lesions: a 20-year follow-up of patients with relapse onset of multiple sclerosis
Abstract
Clinically isolated syndromes (CIS), such as optic neuritis, brainstem or spinal cord syndromes are frequently the first clinical presentations of multiple sclerosis. However, not all CIS patients develop multiple sclerosis and in those who do, disability is highly variable. In previous follow-up studies, brain lesions on T2-weighted MRI are associated with increased risk of multiple sclerosis and to an extent disability. We evaluated the longitudinal relationships between the MRI lesions and clinical course over a period of 20 years. CIS patients were recruited between 1984 and 1987 and previously followed up after 1, 5, 10 and 14 years. Of the 140 subjects who were initially recruited with a CIS for a baseline MRI study, we followed up 107 patients after a mean of 20.2 years (range 18-27.7). Multiple sclerosis was diagnosed as clinically definite on clinical grounds only and disability determined using the Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Functional Composite (MSFC) score. Clinically definite multiple sclerosis developed in 67 out of 107 (63%) overall: 60 out of 73 (82%) with abnormal and 7 out of 34 (21%) with normal baseline MRI. Multiple sclerosis was still relapsing-remitting in 39 (58%)--including 26 (39%) with a 'benign' course (EDSS < or = 3)--whilst 28 (42%) had developed secondary progression. T2 lesion volume at all time-points correlated moderately with 20-year EDSS (r(s) values 0.48 to 0.67; P < 0.001) and MSFC z-score [r(s) values…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
When a patient presents with symptoms or signs that could indicate MS, an MRI is essential as an abnormal brain MRI is seen in virtually all patients with established MS and over 80% of CIS patients who develop MS.
“When a patient presents with symptoms or signs that could indicate MS, an MRI is essential as an abnormal brain MRI is seen in virtually all patients with established MS 7 and over 80% of CIS patients who develop MS. 8”
From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [8]
Conventional brain MRI findings around the time of diagnosis are only modestly predictive of long-term disability and there is uncertainty as to the extent to which criteria for diagnosis and treatment should be linked.
“Conventional brain MRI findings around the time of diagnosis are only modestly predictive of long-term disability 8 and there is uncertainty as to the extent to which criteria for diagnosis and treatment should be linked.”
From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [8]
Cites
Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS)
Kurtzke, J. F. (1983) · Neurology · doi:10.1212/wnl.33.11.1444 · Cited by 15,011 · see citing works
A longitudinal study of abnormalities on MRI and disability from multiple sclerosis
Brex, P. A., Ciccarelli, O., O'Riordan, J. I., Sailer, M., Thompson, A. J., & Miller, D. H. (2002) · New England Journal of Medicine · doi:10.1056/nejmoa011341 · Cited by 861 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Krupp, L. B., Tardieu, M., Amato, M. P., Banwell, B., Chitnis, T., Dale, R. C., Ghezzi, A., Hintzen, R., Kornberg, A., Pohl, D., et al. (2013) · Multiple Sclerosis Journal · doi:10.1177/1352458513484547 · Cited by 1,130 · see citing works
Diagnosis of multiple sclerosis: progress and challenges
Brownlee, W. J., Hardy, T. A., Fazekas, F., & Miller, D. H. (2017) · The Lancet · doi:10.1016/s0140-6736(16)30959-x · Cited by 701 · see citing works
Self-citationMultiple sclerosis: risk factors, prodromes, and potential causal pathways
Ramagopalan, S. V., Dobson, R., Meier, U. C., & Giovannoni, G. (2010) · The Lancet Neurology · doi:10.1016/s1474-4422(10)70094-6 · Cited by 548 · see citing works
Epidemiology of multiple sclerosis
Leray, E., Moreau, T., Fromont, A., & Edan, G. (2016) · Revue Neurologique · doi:10.1016/j.neurol.2015.10.006 · Cited by 478 · see citing works
Luchetti, S., Fransen, N. L., van Eden, C. G., Ramaglia, V., Mason, M., & Huitinga, I. (2018) · Acta Neuropathologica · doi:10.1007/s00401-018-1818-y · Cited by 355 · see citing works
MRI criteria for MS in patients with clinically isolated syndromes
Montalban, X., Tintoré, M., Swanton, J., Barkhof, F., Fazekas, F., Filippi, M., Frederiksen, J., Kappos, L., Palace, J., Polman, C., et al. (2010) · Neurology · doi:10.1212/wnl.0b013e3181cec45c · Cited by 252 · see citing works
Self-citationAlemtuzumab CARE-MS I 5-year follow-up: Durable efficacy in the absence of continuous MS therapy
Havrdova, E., Arnold, D. L., Cohen, J. A., Hartung, H.-P., Fox, E. J., Giovannoni, G., Schippling, S., Selmaj, K. W., Traboulsee, A., Compston, D. A. S., et al. (2017) · Neurology · doi:10.1212/wnl.0000000000004313 · Cited by 221 · see citing works
Chitinase 3-like 1: prognostic biomarker in clinically isolated syndromes
Cantó, E., Tintoré, M., Villar, L. M., Costa, C., Nurtdinov, R., Álvarez-Cermeño, J. C., Arrambide, G., Reverter, F., Deisenhammer, F., Hegen, H., et al. (2015) · Brain · doi:10.1093/brain/awv017 · Cited by 193 · see citing works
Slowly eroding lesions in multiple sclerosis
Sethi, V., Nair, G., Absinta, M., Sati, P., Venkataraman, A., Ohayon, J., Wu, T., Yang, K., Shea, C., Dewey, B. E., et al. (2017) · Multiple Sclerosis Journal · doi:10.1177/1352458516655403 · Cited by 34 · see citing works
- Authors
- Fisniku, L. K., Brex, P. A., Altmann, D. R., Miszkiel, K. A., Benton, C. E., Lanyon, R., Thompson, A. J., & Miller, D. H.
- Affiliations
- UCL Queen Square Institute of Neurology (GB)
- University of London (GB)
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-02-07
- Volume
- 131
- Issue
- 3
- Pages
- 808-817
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- OpenAlex
- W2135900660
- Cited by
- 897
- References
- 2
- Citations by year
- 2026: 21 · 2025: 21 · 2024: 32 · 2023: 33 · 2022: 24 · 2021: 47 · 2020: 40 · 2019: 50 · 2018: 57 · 2017: 65 · 2016: 71 · 2015: 61 · 2014: 56 · 2013: 60 · 2012: 71
- FWCI
- 44.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Brain (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
- Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
- Keywords
- multiple sclerosis, clinically isolated syndrome, lesion volume, disability progression, secondary progressive multiple sclerosis, relapsing-remitting multiple sclerosis, Expanded Disability Status Scale, Multiple Sclerosis Functional Composite, lesion growth rate, optic neuritis, brainstem syndrome, spinal cord syndromes, long-term follow-up, conversion to multiple sclerosis, disease progression prediction
- MeSH terms
- Adolescent, Adult, Brain, Disability Evaluation, Female, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Male, Middle Aged, Multiple Sclerosis, Optic Neuritis, Prognosis, Prospective Studies, Spinal Cord Diseases, Disease Progression, Multiple Sclerosis, Chronic Progressive, Multiple Sclerosis, Relapsing-Remitting
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
