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Multiple Sclerosis
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1352458506070758v1
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Article

Relationship of triple dose contrast enhanced lesions with clinical measures and brain atrophy in early relapsing-remitting multiple sclerosis: a two-year longitudinal study

W Rashid1, G R Davies1, D T Chard1, C M Griffin1, D R Altmann1, A J Thompson2, D H Miller1*

1 Department of Neuroinflammation, MS NMR Research Unit, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
2 Department of Headache, Brain Injury and Rehabilitation, MS NMR Research Unit, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK

* To whom correspondence should be addressed.


  Abstract

Gadolinium (Gd) enhancement of lesions indicates inflammatory lesion activity in multiple sclerosis (MS). The question arises whether early inflammatory lesion activity - measured sensitively using triple dose Gd - is related to the future clinical course, or to the development of brain atrophy that is thought to reflect the underlying pathological progression of the disease. In this study, 26 patients with early relapsing-remitting (RR) MS (median disease duration: 1.7 years) were followed up over two years. Associations were explored between their levels of Gd-lesion enhancement in the first six months and later clinical (Expanded Disability Status Scale (EDSS) and MS Functional Composite Score (MSFC)) and magnetic resonance imaging (MRI) (brain volume, T2 and T1 lesion volumes) measures. The extent of Gd-enhancement in the first six months correlated weakly with concurrent relapses (P=0.041), but there was no consistent correlation with clinical and MRI outcomes at two years. More prolonged follow-up is warranted to clarify the relationship between early inflammatory lesions and long-term clinical course.

Key Words: atrophy, EDSS, gadolinium, inflammation, MRI, MSFC, multiple sclerosis

First published on January 29, 2007, doi:10.1177/1352458506070758

Multiple Sclerosis 2007;13:178.

A more recent version of this article appeared on March 1, 2007

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