American Journal of Neuroradiology 24:75-81, January 2003
© 2003 American Society of Neuroradiology
BRAIN
Short-Term Correlations between Clinical and MR Imaging Findings in Relapsing-Remitting Multiple Sclerosis
a Neuroimaging Research Unit, Department of Neuroscience, Scientific Institute and University Ospedale San Raffaele, Milan, Italy
b Clinical Trials Unit, Department of Neuroscience, Scientific Institute and University Ospedale San Raffaele, Milan, Italy
c TEVA Pharmaceutical Industries, Petah Tiqva, Israel
d University of Texas-Houston, Health Science Center
Address reprint requests to Dr Massimo Filippi, Neuroimaging Research Unit, Department of Neuroscience, Scientific Institute and University Ospedale San Raffaele, via Olgettina 60, 20132 Milan, Italy
BACKGROUND AND PURPOSE: Despite extensive use of MR imaging to provide markers of multiple sclerosis (MS) activity and accumulated disease burden, the magnitude of the relationship between clinical and MR findings is still debated. Using data from the European/Canadian glatiramer acetate (GA) trial, we investigated short-term correlations between clinical and MR measures of disease activity in patients with relapsing-remitting MS (RRMS).
METHODS: In a 9-month, double-blinded, placebo-controlled study, 239 patients with RRMS were randomly assigned to receive 20 mg GA (n = 119) or placebo (n = 120). Clinical assessment included monthly neurologic examinations with Expanded Disability Status Scale scoring and visits for symptoms suggestive of relapse. Dual-echo T2-weighted and pre- and postcontrast T1-weighted brain MR images were obtained at baseline and monthly during follow-up. Contrast-enhancing and new T2-hyperintense lesions were counted, and total T2-hyperintense and T1-hypointense lesion volumes were measured.
RESULTS: Significant univariate correlations were found between the number of relapses during the study period and the number of enhancing lesions at baseline (r = 0.25) and during follow-up (r = 0.30) in the study population as a whole. Multivariable analysis showed that two independent factors were more strongly correlated with relapse frequency: the number of relapses during the 2 years before entry and the number of on-trial enhancing lesions, in the whole study population and in the placebo group.
CONCLUSION: In RRMS, MR imaging measures of inflammatory activity are modestly but significantly correlated with the occurrence of clinical attacks over the short term. Clinical and MR imaging assessment can provide complementary outcome measures for RRMS trials.
This article has been cited by other articles:
 |
|
 |
|
  D Cadavid, J Cheriyan, J Skurnick, J A Lincoln, L J Wolansky, and S D Cook New acute and chronic black holes in patients with multiple sclerosis randomised to interferon beta-1b or glatiramer acetate J. Neurol. Neurosurg. Psychiatry, December 1, 2009; 80(12): 1337 - 1343. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. M. Zackowski, S. A. Smith, D. S. Reich, E. Gordon-Lipkin, B. A. Chodkowski, D. R. Sambandan, M. Shteyman, A. J. Bastian, P. C. van Zijl, and P. A. Calabresi Sensorimotor dysfunction in multiple sclerosis and column-specific magnetization transfer-imaging abnormalities in the spinal cord Brain, May 1, 2009; 132(5): 1200 - 1209. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Daumer, A. Neuhaus, S. Morrissey, R. Hintzen, and G. C. Ebers MRI as an outcome in multiple sclerosis clinical trials Neurology, February 24, 2009; 72(8): 705 - 711. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A Minneboo, B Jasperse, F Barkhof, B M J Uitdehaag, D L Knol, V de Groot, C H Polman, and J A Castelijns Predicting short-term disability progression in early multiple sclerosis: added value of MRI parameters J. Neurol. Neurosurg. Psychiatry, August 1, 2008; 79(8): 917 - 923. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. P. Sormani, M. Rovaris, G. Comi, and M. Filippi A composite score to predict short-term disease activity in patients with relapsing-remitting MS Neurology, September 18, 2007; 69(12): 1230 - 1235. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D.K.B. Li, U. Held, J. Petkau, M. Daumer, F. Barkhof, F. Fazekas, J. A. Frank, L. Kappos, D. H. Miller, J. H. Simon, et al. MRI T2 lesion burden in multiple sclerosis: A plateauing relationship with clinical disability Neurology, May 9, 2006; 66(9): 1384 - 1389. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. Held, L. Heigenhauser, C. Shang, L. Kappos, C. Polman, and for the Sylvia Lawry Centre for MS Research Predictors of relapse rate in MS clinical trials Neurology, December 13, 2005; 65(11): 1769 - 1773. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. T. Naismith and A. H. Cross Multiple Sclerosis and Black Holes: Connecting the Pixels Arch Neurol, November 1, 2005; 62(11): 1666 - 1668. [Full Text] [PDF]
|
|
|
|
|
|
B. A. Cohen, O. Khan, D. R. Jeffery, K. Bashir, S. A. Rizvi, E. J. Fox, M. Agius, R. Bashir, T. E. Collins, R. Herndon, et al. Identifying and treating patients with suboptimal responses Neurology, December 28, 2004; 63(12_suppl_6): S33 - S40. [Abstract] [Full Text]
|
|
|
|
|
|
D. R. Jeffery Use of combination therapy with immunomodulators and immunosuppressants in treating multiple sclerosis Neurology, December 28, 2004; 63(12_suppl_6): S41 - S46. [Abstract] [Full Text]
|
|
|
|
|
|
M. Rovaris, F. Agosta, M. P. Sormani, M. Inglese, V. Martinelli, G. Comi, and M. Filippi Conventional and magnetization transfer MRI predictors of clinical multiple sclerosis evolution: a medium-term follow-up study Brain, October 1, 2003; 126(10): 2323 - 2332. [Abstract] [Full Text] [PDF]
|
|