M. Filippi et al., QUANTITATIVE BRAIN MRI LESION LOAD PREDICTS THE COURSE OF CLINICALLY ISOLATED SYNDROMES SUGGESTIVE OF MULTIPLE-SCLEROSIS, Neurology, 44(4), 1994, pp. 635-641
We performed semiautomated quantitative measurement of brain magnetic
resonance imaging (MRI) abnormalities seen at presentation and at 5-ye
ar follow-up in 84 patients presenting with an acute clinically isolat
ed syndrome of the optic nerves, brainstem, or spinal cord suggestive
of multiple sclerosis (MS). At follow-up, 34 (40%) had developed clini
cally definite and four (5%) clinically probable MS. Patients who deve
loped MS during followup had a higher lesion load at presentation than
those who did not. There was a strong correlation of the MRI lesion l
oad at presentation with both the increase in lesion load over the nex
t 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 wer
e 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 cours
e and the development of new MRI lesions. This suggests that quantitat
ive brain MRI will be helpful in selecting patients with early clinica
l MS for treatment trials and for subsequent monitoring of their respo
nse to treatment.