Magnetic resonance imaging in the monitoring of disease progression in multiple sclerosis

Disease progression and irreversible disability in multiple sclerosis resul ts from incomplete recovery from relapses, but most importantly from insidi ous disease progression. Although magnetic resonance imaging parameters, su ch as new lesion rate and gadolinium enhancement, reflect inflammation and disease activity they have no bearing on disease progression. Until now the T2 lesion load or disease burden has been relied upon for this, despite it s poor relationship with disability measures. This paper looks at the mecha nisms responsible for disease progression and discusses the MR techniques n ow available to reflect these pathological processes.