CLINICAL WORSENING IN MULTIPLE-SCLEROSIS IS ASSOCIATED WITH INCREASEDFREQUENCY AND AREA OF GADOPENTETATE DIMEGLUMINE ENHANCING MAGNETIC-RESONANCE-IMAGING LESIONS

Citation
Me. Smith et al., CLINICAL WORSENING IN MULTIPLE-SCLEROSIS IS ASSOCIATED WITH INCREASEDFREQUENCY AND AREA OF GADOPENTETATE DIMEGLUMINE ENHANCING MAGNETIC-RESONANCE-IMAGING LESIONS, Annals of neurology, 33(5), 1993, pp. 480-489
Citations number
33
Categorie Soggetti
Clinical Neurology",Neurosciences
Journal title
ISSN journal
03645134
Volume
33
Issue
5
Year of publication
1993
Pages
480 - 489
Database
ISI
SICI code
0364-5134(1993)33:5<480:CWIMIA>2.0.ZU;2-B
Abstract
It is now well established that clinically stable patients with relaps ing-remitting multiple sclerosi have ongoing disease activity when eva luated by serial gadolinium-enhanced (Gd-DTPA) magnetic resonance imag ing (MRI) scans. Despite this, the relationship between clinical disea se and MRI lesions, though suspected, has not been extensively documen ted. The relationship between Gd-DTPA MRI lesions and clinical disease was examined in this study of 9 patients with mild relapsing-remittin g multiple sclerosis (Expanded Disability Status Scale [EDSS] <3.5) wh o had 24 to 37 monthly Gd-DTPA MRI scans, neurological examinations, a nd EDSS score assignments. The area and frequency of Gd-DTPA lesions w ere examined during months with and without clinical worsening as meas ured by EDSS. Forty-one episodes of clinical worsening were noted duri ng the study. A significant association was observed between these per iods of clinical worsening and MRI parameters, including increases in total number, number of new lesions, and the total area of enhancement . Logistic regression analysis showed a significant effect of the numb er and area of Gd-DTPA MRI lesions on both the onset and continuation of clinical worsening, confirming an important relationship between cl inical disease and an increase in cerebral Gd-DTPA MRI activity. A rel ationship with long-term disability was suggested, but cannot be confi rmed without longer follow-up of these patients.