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Two-year follow-up study of primary and transitional progressive multiple sclerosis

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

V L Stevenson

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

S M Leary

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

M Rovaris

Neuroimaging Research Unit, Department of Neuroscience, Scientific Institute and University Ospedale San Raffaele, University of Milan, Milan, Italy

F Barkhof

Department of Diagnostic Radiology, Free University Hospital, Amsterdam, The Netherlands

B Brochet

Departement de Neurologie CHU-Hôpital Pellegrin, Bordeaux, France

V Dousset

Service de Neurologie, CHU-Hôpital Pellegrin, Bordeaux, France

M Filippi

Neuroimaging Research Unit, Department of Neuroscience, Scientific Institute and University Ospedale San Raffaele, University of Milan, Milan, Italy

X Montalban

Unitat de Ressonancia Magnetica, Centre Vall d’Hebron, Institut de Diagnostic per la Imatge, Pg. Vall d’Hebron 119-129, 08035 Barcelona, Spain

N F Kalkers

Department of Diagnostic Radiology, Free University Hospital, Amsterdam, The Netherlands

C H Polman

Department of Diagnostic Radiology, Free University Hospital, Amsterdam, The Netherlands

A Rovira

Unitat de Ressonancia Magnetica, Centre Vall d’Hebron, Institut de Diagnostic per la Imatge, Pg. Vall d’Hebron 119-129, 08035 Barcelona, Spain

A J Thompson

NMR Research Unit, Institute of Neurology, Queen Square, London WC1N 3BG, UK, a.thompson{at}ion.ucl.ac.uk

This study documents changes in clinical and magnetic resonance imaging (MRI) characteristics in a large cohort of patients with primary and transitional progressive multiple sclerosis (PP and TPMS) over 2 years. Patients with PPMS and TPMS were recruited from six European centres and underwent clinical and MRI examination at three time points: baseline, year one and year two. Of the 190 patients recruited clinical data were available on 125 patients (66%, five centres) and MRI data were available on 113 patients (59%, four centres) at 2 years. Significant increases were seen in T2 load and T1 hypointensity, while brain and cord volume decreased. In PPMS significantly higher lesion loads were found in those who presented with non-cord syndromes when compared to cord presentation and there was a trend to greater brain atrophy in those who deteriorated clinically over the course of the study compared to those who remained stable. Significant cord atrophy was only seen in those with a cord presentation. Measurable changes in MRI parameters can be detected in PPMS patients over a relatively short period of time. MRI quantification is likely to be useful in elucidating disease mechanisms in PPMS and in the execution of clinical trials.

Key Words: chronic progressive • cohort studies • disease progression • follow-up studies • magnetic resonance imaging • multiple sclerosis

Multiple Sclerosis, Vol. 8, No. 2, 108-114 (2002)
DOI: 10.1191/1352458502ms778oa


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