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A 3‐year magnetic resonance imaging study of cortical lesions in relapse‐onset multiple sclerosis
Author(s) -
Calabrese Massimiliano,
Rocca Maria A.,
Atzori Matteo,
Mattisi Irene,
Favaretto Alice,
Perini Paola,
Gallo Paolo,
Filippi Massimo
Publication year - 2010
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.21906
Subject(s) - expanded disability status scale , multiple sclerosis , magnetic resonance imaging , medicine , white matter , lesion , atrophy , nuclear medicine , cls upper limits , pathology , radiology , psychiatry , optometry
Objective We assessed the occurrence, extent, and frequency of formation of cortical lesions (CLs) in patients with relapsing‐remitting (RR) and secondary progressive (SP) multiple sclerosis (MS), and their relationship with cortical atrophy and disability progression. Methods One‐hundred seven MS patients (76 RRMS and 31 SPMS), enrolled in a prospective, longitudinal magnetic resonance imaging (MRI) study, were assessed clinically and by brain MRI (including a double inversion recovery sequence) 3 years after study initiation. CL number and volume, T2 white matter (WM) lesion volume, gray matter fraction, and expanded disability status scale (EDSS) were measured. Results At baseline, CLs were detected in 64.4% of RRMS and 74.2% of SPMS patients. During follow‐up, 132 new CLs were found in 44 RRMS patients (57.9%; 0.8 new CL/patient/yr) and 61 in 15 SPMS patients (48.4%; 1.0 new CL/patient/yr). Among these patients, only 31 also showed at least 1 new WM lesion. CL number and volume increases were higher in the 52 patients with a clinical worsening compared with those without ( p < 0.001). Baseline CL volume correlated with baseline EDSS ( r = 0.36, p < 0.001) and EDSS changes over time ( r = 0.51, p < 0.001). Baseline CL volume was an independent predictor of EDSS accumulation and GM volume change at follow‐up in both patient groups. In SPMS patients, baseline T2 WM lesion volume was another independent predictor of EDSS worsening. Interpretation In relapse‐onset MS, CLs accumulate over time and are associated with disability progression. The quantification of CLs might represent an additional useful paraclinical tool to monitor MS evolution. ANN NEUROL 2010;67:376–383