Magnetic Resonance Imaging Anomalies May Predict Multiple Sclerosis
NEW YORK, March 27, 2009 — Patients with incidental magnetic resonance imaging (MRI) anomalies suggestive of multiple sclerosis (MS) appear to be at increased risk of the condition, said researchers at the University of California, San Francisco. The degree of risk remains to be determined, however.
"We are capturing MS at an earlier timeframe," lead investigator Dr Darin T. Okuda, a Neurologist at the University of California, San Francisco MS Center, told Reuters Health. "Our current research efforts aim to stratify individuals into varying categories of risk for conversion to either CIS—clinically isolated syndrome—or clinically definite MS."
Dr Okuda et al obtained clinical and radiological data on 44 asymptomatic patients with MRI anomalies suggestive of MS. Neurological examination showed normal results in almost all patients at the time of the original MRI scans. Longitudinal clinical follow-up data was available in 30 patients and longitudinal MRI data in 41.
In the March 3 issue of Neurology, the authors reported that 24 of 41 patients (59%) showed radiologic progression over a median time period of 2.7 years. Conversion to either CIS or definite MS occurred in only 10 patients, over a median period of 5.4 years.
Patients with gadolinium-enhancing lesions on MRI at baseline had "a substantial increase in risk" (hazard ratio, 3.4) for dissemination in time on repeat brain imaging compared to patients without such lesions at baseline, the researchers said.
Additional studies will be required to better define the risks, said the investigators. However, added Dr Okuda, "We hope to one day study the effects of disease modifying therapies within this high-risk group to assess whether we can prevent MS from ever occurring in these individuals."
In an accompanying editorial, Drs Dennis Bourdette and Jack Simon of the Oregon Health and Science University in Portland, observe that for the present, the study "sets the stage for establishing a formal process by which asymptomatic patients might be evaluated and followed when they present with MRI findings highly suggestive of MS."
Source: Reuters Health Information
