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Magnetic resonance imaging predictors of disability in primary progressive multiple sclerosis: a 5-year study

Department of Clinical Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK, val.stevenson{at}uclh.org

G T Ingle

Department of Clinical Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK

D H Miller

Department of Clinical Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK

A J Thompson

Department of Clinical Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK

Magnetic resonance imaging (MRI) has become an accepted tool for monitoring therapeutic trials in relapsing-remitting and secondary progressive multiple sclerosis (MS); it is however unclear whether such MRI markers are equally applicable to primary progressive MS (PPMS). Forty-two patients with PPMS were reviewed five years after commencing a two-year MRI and clinical study. Clinical measures recorded at baseline and five years included both the Expanded Disability Status Scale and the MS functional composite. MRI data collected at baseline and two years included T1 and T2 lesion loads, the number of new brain and cord lesions, and measures of both brain and cord atrophy. The study demonstrated that both the number of new T2 lesions and rate of increase in ventricular volume over two years were modestly predictive of subsequent disease progression and therefore may be useful tools in the testing of new therapeutic agents in PPMS.

Key Words: disability • MRI • primary progressive multiple sclerosis

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