NEW YORK (Reuters Health) – In patients with symptoms suggestive of multiple sclerosis (MS), brain MRI findings during the first 5 years may be able to predict long-term disability, according to a report published in the January 17th issue of The New England Journal of Medicine.
The ability to identify early correlates of future disability may have important implications for disease-modifying treatments, which may be most effective when given before irreversible changes have occurred.
Dr. David H. Miller, from the Institute of Neurology in London, and colleagues assessed the predictive value of brain MRI in 71 patients with isolated neurologic syndromes suggestive of MS. The average follow-up period was 14.1 years.
Of the 50 patients with abnormal baseline MRI results, 44 developed MS. In contrast, only 4 of the 21 patients with normal MRI results developed MS, the authors note.
On a 10-point disability scale, with 10 representing the greatest disability, MS patients achieved a median score of 3.25 at follow-up. However, nearly one third of MS patients had scores of 6 or higher, the researchers state.
MRI lesion volume at 5 years correlated moderately with the disability score at 14 years, the investigators note. An increase in lesion volume during the first 5 years was also a predictor of long-term disability.
While the current findings indicate that early MRI findings may be able to predict long-term disability, the authors caution that the correlations were only moderate. Hence, lesion volume and change on MRI probably should not be the sole determinants of whether to institute disease-modifying treatments.
In an accompanying editorial, Dr. Donald W. Paty, from Vancouver Hospital, Canada, and Dr. Douglas L. Arnold, from Montreal Neurological Hospital, suggest that "the opportunity for effective treatment may be greatest if patients are treated at the very earliest stages."
Studies such as the current one "will permit a better understanding of the impact of disease-modifying drugs on specific abnormalities in multiple sclerosis and, along with clinical examination, will provide more insight into the evolution and prognosis of the disease," the editorialists state.
e-Med Tools
קצר קולע וממוקד
e-Med סמינרים
אי-מד תחקירים
Medscape Tools
Journal Club
מרכזי מידע ושירות
Facebook
מידע למפרסם
מאגר תרופות
מאגר אנשי המקצוע
אינדקס שימושי
חדשות משה"ב
eMed HealthClub
מחקרים קליניים
השאירו תגובה
רוצה להצטרף לדיון?תרגישו חופשי לתרום!