BRAIN AND SPINAL-CORD ABNORMALITIES IN MULTIPLE-SCLEROSIS - CORRELATION BETWEEN MRI PARAMETERS, CLINICAL SUBTYPES AND SYMPTOMS

We investigated various magnetic resonance MRI parameters for both bra in and spinal cord to see if any improved the clinicoradiological corr elation in multiple sclerosis. Ninety-one multiple sclerosis patients (28 relapsing-remitting, 32 secondary progressive and 31 primary progr essive) were imaged using conventional T-1, proton density-and T-2-wei ghted MRI of the brain and spinal cord. Focal brain and spinal cord le sion load was scored, as were diffuse signal abnormalities, brain vent ricular volume and spinal cord cross-sectional area. Clinical measures included the expanded disability status scale (EDSS), the functional systems score and a dedicated urology complaint questionnaire. Seconda ry progressive patients differed from relapsing-remitting and primary progressive patients by a larger number of hypointense T-1 lesions in the brain, ventricular enlargement and spinal cord atrophy. Primary pr ogressive patients more often had diffuse abnormalities in the brain a nd/or spinal cord than did relapsing-remitting and secondary progressi ve patients, ln The entire study population, EDSS correlated with both brain and spinal cord MRI parameters, which were independent. The uro logical complaint score correlated only with spinal cord MRI parameter s. In relapsing-remitting and secondary progressive multiple sclerosis , the correlation between MRI and clinical parameters Mins better than in the entire population. In this subgroup EDSS variance could be exp lained best by T-1 brain lesion load, ventricle volume and spinal cord cross-sectional area. In the primary progressive subgroup the clinico radiological correlation was weak for brain parameters but was present between spinal cord symptoms and spinal cord MRI parameters. In concl usion, the different brain and spinal cord MRI parameters currently av ailable revealed considerable heterogeneity between clinical subtypes of multiple sclerosis. In relapsing-remitting and secondary progressiv e multiple sclerosis both brain and spinal cord MRI may provide a tool for monitoring patients, while in primary progressive multiple sclero sis the clinicoradiological correlation is weak for brain imaging.