MRI Measures And Their Relations With Clinical Disability In Relapsing/Remitting And Secondary/Progressive Multiple Sclerosis
Giugni E, Pozzilli C, Bastianello S, Gasperini C, Paolillo A, Koudriavtseva T, Frontoni M, Farina D, Bozzao L
Mult Scler 1997 Aug;3(4):221-5
Univ La Sapienza of RomeDept of Neurological Sciences, Italy
PMID# 9372503; UI# 98039772
To further evaluate the relationship between clinical disability and Magnetic Resonance Imaging (MRI) lesion burden, we examined 85 patients with Clinically Definite Multiple Sclerosis (54 Relapsing/Remitting and 31 Secondary/Progressive).
This cross-sectional study reports on the correlations between total and InfraTentorial lesion volume on both T1 and T2 weighted images, and overall physical disability measured by Expanded Disability Status Scale, Ambulation Index and individual Functional Systems.
Assessment of the HypoIntense lesion load on T1 weighted images rather than the HyperIntense lesion load on T2 weighted images at Brain MRI was shown to be useful for differentiating Relapsing/Remitting from Secondary/Progressive Multiple Sclerosis.
A weak relationship between disability and total lesion volume on both T1 and T2 weighted images was found in Relapsing/Remitting Multiple Sclerosis.
In Secondary/Progressive Multiple Sclerosis, InfraTentorial lesion volume on T2 weighted images represents the only marker of disability.
Finally, the presence of Cerebellar, BrainStem and mental impairment was significantly associated to a greater total lesion volume on MRI, while no relationship was found with other functional systems.
Brain And Spinal Cord Abnormalities
In Multiple Sclerosis: Correlation Between MRI Parameters, Clinical Subtypes And Symptoms
Nijeholt GJ, van Walderveen MA, Castelijns JA, van Waesberghe JH, Polman C, Scheltens P, Rosier PF, Jongen PJ, Barkhof F
Brain 1998 Apr;121 ( Pt 4):687-97
Vrije Universiteit Hospital, Dept of Radiology, Amsterdam, The Netherlands
PMID# 9577394; UI# 98238255
We investigated various Magnetic Resonance MRI parameters for both Brain and Spinal Cord to see if any improved the ClinicoRadiological correlation in Multiple Sclerosis.
Ninety-one Multiple Sclerosis patients were imaged using Conventional T1, Proton Density- and T2-weighted MRI of the Brain and Spinal Cord
- 28 Relapsing/Remitting
- 32 Secondary/Progressive
- 31 Primary/Progressive
Focal Brain and Spinal Cord lesion load was scored, as were diffuse signal abnormalities, Brain Ventricular 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.
Secondary/Progressive patients differed from Relapsing/Remitting and Primary/Progressive patients by a larger number of HypoIntense T1 lesions in the Brain, Ventricular enlargement and Spinal Cord Atrophy.
Primary/Progressive patients more often had diffuse abnormalities in the Brain and/or Spinal Cord than did Relapsing/Remitting and Secondary/Progressive patients.
In the entire study population, EDSS correlated with both Brain and Spinal Cord MRI parameters, which were independent. The Urological complaint score correlated only with Spinal Cord MRI parameters.
In Relapsing/Remitting and Secondary/Progressive Multiple Sclerosis, the correlation between MRI and clinical parameters was better than in the entire population.
In this subgroup EDSS variance could be explained best by T1 Brain lesion load, Ventricle volume and Spinal Cord cross-sectional area.
In the Primary/Progressive subgroup the ClinicoRadiological correlation was weak for Brain parameters but was present between Spinal Cord symptoms and Spinal Cord MRI parameters.
In conclusion, the different Brain and Spinal Cord MRI parameters currently available revealed considerable Heterogeneity between clinical subtypes of Multiple Sclerosis.
In Relapsing/Remitting and Secondary/Progressive Multiple Sclerosis both Brain and Spinal Cord MRI may provide a tool for monitoring patients, while in Primary/Progressive Multiple Sclerosis the ClinicoRadiological correlation is weak for Brain imaging.
Correlation Between Brain MRI Lesion Volume And Disability In Multiple Sclerosis
Mammi S, Filippi M, Martinelli V, Campi A, Colombo B, Scotti G, Canal N, Comi G
Acta Neurol Scand 1996 Aug;94(2):93-6
Univ of Milan, Scientific Institute, Ospedale S. Raffaele, Dept of Neurology, Italy
PMID# 8891052; UI# 97046130
In this study we evaluated the relationships between clinical variables and lesion volumes measured from Magnetic Resonance Imaging (MRI) scans in a large cohort of Multiple Sclerosis (MS) patients.
One hundred and thirty patients with MS entered the study
- 36 patients had Relapsing/Remitting (RR)
- 39 Benign (B)
- 42 Secondary/Progressive (SP)
- 13 Primary/Progressive (PP)
There was a significant correlation (r = 0.3; p = 0.0006) between the total lesion load and the EDSS score when the whole cohort of patients was considered.
This correlation increased (r = 0.5) when only patients with RRMS and SPMS were considered. Our data indicate that a correlation between disability and MRI lesion volume in MS exists, but its strength is moderate.
Cognitive Impairment In Early-Onset Multiple Sclerosis Pattern, Predictors, And Impact On Everyday Life
In A 4-Year Follow-Up
Amato MP, Ponziani G, Pracucci G, Bracco L, Siracusa G, Amaducci L
Arch Neurol 1995 Feb;52(2):168-72
Univ of Florence, Dept of Neurology, Italy
PMID# 7848126; UI# 95150856
To assess the evolution of Cognitive dysfunction in early-onset Multiple Sclerosis, to identify clinical predictors of mental decline, and to determine its impact on a patient's everyday life.
The Cognitive performance of 50 patients with Multiple Sclerosis on a NeuroPsychological battery was compared with that of 70 control subjects initially and again after a 4-year interval.
Clinical predictors of Cognitive Impairment and its effect on daily life were analyzed by stepwise linear regression.
The research clinic of a university department of Neurology.
A consecutive sample of 50 inpatients and outpatients with Multiple Sclerosis (mean disease duration, 1.58 years) and 70 demographically matched healthy control subjects selected from the patients' relatives and friends.
Main Outcome Measures
Mean psychometric test scores of both groups at the initial and follow-up testing.
Regression coefficients measuring the relationship between clinical parameters and Cognitive capacity and between mental decline and performance of common tasks measured by the Environmental and the Incapacity Status scales.
Multiple Sclerosis-related deficits in Verbal Memory and Abstract Reasoning on initial testing remained more or less stable on the retest, at which time Linguistic disturbances on the Set and Token tests also emerged.
A patient's initial disability level predicted decreased performance on only four of 13 Cognitive variables, and disease duration did so on only two.
Extent of intellectual decline on initial testing, initial disability level, and Progressive course were independent determinants of handicap in a patient's work and social activities.
Cognitive and Neurological Deficits appear not to develop in parallel. Yet Cognitive dysfunction proves to be a predictor of handicap in everyday life, even in patients in the incipient phase of Multiple Sclerosis.
NeuroPsychological, NeuroRadiological And Clinical Findings In MS: A Three Year Follow-Up Study
Patti F, Failla G, Ciancio MR, L'Episcopo MR, Reggio A
Eur J Neurol 1998 May;5(3):283-286
Istituto di Scienze Neurologiche, Servizio di Neuroriabilitazione e Sclerosi Multipla, Policlinico dell'Universita di Catania, viale Andrea Doria 6, 95125 Catania, Catania, Italy
Cognitive Impairment is a frequent feature in Multiple Sclerosis patients. To assess its evolution in comparison with clinical and NeuroRadiological evolution, we followed up 57 Multiple Sclerosis patients over a 3-year period.
During this time EDSS deteriorated significantly but not the MRI lesional load nor the Cognitive test performance.
Nevertheless, both at the beginning and at the end of the follow-up NeuroPsychological results showed a significant correlation with both EDSS and lesional load.
No clinical or paraclinical features could reliably predict NeuroPsychological evolution.
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