CORRELATING IMMUNOLOGICAL AND MAGNETIC-RESONANCE-IMAGING MARKERS OF DISEASE-ACTIVITY IN MULTIPLE-SCLEROSIS

Inflammation plays a central part in the pathogenesis of multiple scle rosis. However, current surrogate magnetic resonance (MR) and immunolo gical markers of inflammation are weakly associated and correlate poor ly with clinical progression. Reasons for this are multiple and probab ly relate to the non-specific changes and insensitivity of current MR techniques, disease dynamics, anatomicaI factors, and the temporal pro file and poorly defined complexities of the inflammatory reaction in m ultiple sclerosis. This paper provides an overview of the principles i nvolved in the monitoring of inflammation in multiple sclerosis, discu sses possible reasons for the weak correlation between MR and immunolo gical markers of inflammation, and briefly reviews the studies correla ting these modalities. In addition, the predictive values of MRI and C SF oligoclonal immunoglobulin are compared in determining future progr ession to clinically definite multiple sclerosis in patients presentin g with clinically isolated syndromes compatible with demyelination.