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The predictive value of gadolinium enhancement for long term disability in relapsing-remitting multiple sclerosis-preliminary results

NMR Research Unit, Institute of Neurology, Queen Square, London WC1N 3BG, UK

D H Miller

NMR Research Unit, Institute of Neurology, Queen Square, London WC1N 3BG, UK

D Kidd

NMR Research Unit, Institute of Neurology, Queen Square, London WC1N 3BG, UK

A J Thompson

NMR Research Unit, Institute of Neurology, Queen Square, London WC1N 3BG, UK

As short-term MRI studies are increasingly being used to monitor disease activity in multiple sclerosis (MS) it is vital to establish if short-term MRI activity is predictive of long term clinical outcome. We followed up after 5 years a group of 10 benign (relapsing-remitting MS with a disease duration 410 years and EDSS 43) and 10 early relapsing-remitting patients who previously had monthly serial MRI scans for 6 months. In the early relapsing-remitting group median EDSS at entry to the initial serial study was three and in the benign group 2.5. At 5-year follow up, five of these 20 patients had developed a definite deterioration in EDSS. The median number of new enhancing lesions detected originally in the group that had deteriorated was 11 (7-17) compared to 0 (0-5) new enhancing lesions, for those who had not deteriorated (P50.05). There was a trend towards a higher baseline T2 lesion load in the group with a definite change in EDSS but this was not significant. This study suggests that short-term measurement of the number of gadolinium enhancing lesions may predict long term outcome in relapsing-remitting MS.

Key Words: MS • enhancement • prediction • disability

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