Patterns Of Brain Magnetic Resonance Abnormalities
On T2-Weighted Spin Echo Images
In Multiple Sclerosis Clinical Subgroups

A large cross-sectional Study

van Walderveen MA, Barkhof F, Tas MW, Polman C, Frequin ST, Hommes OR, Thompson AJ, Valk J
Eur Neurol 1998 Aug;40(2):91-8
Academic Hospital 'Vrije Universiteit', MR Center for MS Research and Depts of Radiology, Amsterdam, The Netherlands
PMID# 9693238; UI# 98359977

To substantiate differences in Magnetic Resonance (MR) patterns in clinical subgroups of Multiple Sclerosis (MS), we analyzed T2-weighted MR images of a large regional population of MS patients (n = 188).

The patients had already been classified according to recent consensus definitions regarding the clinical course of MS into Relapsing/Remitting (R/R), Secondary/Progressive (S/P) or Primary/Progressive (P/P).

Significant (p < 0.01; Spearman test) differences were present between R/R and S/P patients regarding total lesion load, size and location of lesions. R/R and P/P patients showed similar MR patterns.

P/P and S/P patients differed in total Lesion Load, small and medium-sized Lesions. The degree of Atrophy was highest for SP patients.

The clinical progression rate [Expanded Disability Status Scale (EDSS)/disease duration] was similar for various subgroups; the MR progression rate (total lesion score/disease duration) was significantly larger for S/P than for P/P patients.

The lesions load disability quotient (total lesion load/EDSS) differed between R/R and P/P patients and also between S/P and P/P patients.

In S/P patients, the total Lesion Load correlated significantly (Spearman rank correlation coefficient of 0.52) with EDSS. We conclude:

  1. P/P patients differ in MR abnormalities from S/P patients
  2. P/P and R/R patients have similar MR abnormalities
  3. R/R and S/P patients are at a different end of the same spectrum of the disease

As the dynamics and clinical impact of MS lesions are different in the various clinical subgroups, they should be considered separately in clinical trials.

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