MRI scans may predict the future for MS patients
MRI scans of people living with multiple sclerosis could predict how their condition will progress – including how disabled they are likely to be.
The MS Society-funded study followed 164 people with clinically isolated syndrome (CIS) over a 15-year period.
Monitoring how MS developed, researchers discovered that MRI scans from when individuals were first diagnosed contained signs of future progression.
For example, early spinal cord damage indicated people were much more likely to go on to develop the secondary progressive form of MS, which currently has no treatment and is where disability gets steadily worse.
A spinal cord MRI indicated the level of disability a person was likely to face in future.
They also found an association between lesions seen in the brain at the time of CIS and a person’s physical and cognitive performance later in life.
More than 100,000 people live with MS in the UK and one of the most difficult things about being diagnosed is the uncertainty of the condition.
The course MS takes is highly variable, with significant differences in terms of how quickly it progresses, how disabled a person may become and how cognitive performance is affected.
Dr Susan Kohlhaas, director of research at the MS Society, said: “MS damages nerves in your body and makes it harder to do everyday
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things like walk, talk, eat and think.
“It’s also different for everyone and there isn’t currently a consistent way of predicting what course MS might take.
“By identifying key factors that appear very early on and indicate how someone’s MS might develop, this study has proved crucial.”
After 15 years, all participants were followed up with, and their disability was assessed using, measures including the expanded disability status scale (EDSS).
Some 94 (57%) had the relapsing form of multiple sclerosis, 25 (15%) had the secondary progressive form, 45 (27%) remained CIS and two people (1%) had developed other disorders.
As well as knowing how a person’s condition might progress – and being able to plan for their future accordingly – this information will help healthcare professionals personalise treatment plans, which is particularly important for patients identified as highrisk for disease progression.
A recent study suggested early intensive treatment leads to a better MS prognosis – but without information about how a person’s disease is likely to progress, it can be challenging to make such a decision.
The study was led by Dr Wallace Brownlee and MS Society scientific ambassador Professor Olga Ciccarelli.
Dr Brownlee said: “We already use MRI scans to diagnose MS and to monitor the course of the disease. These findings – which suggest existing measures, routinely available in clinical practice, can provide a long-term prognosis – are a major advance that will be welcomed by many in the MS community.”
The new research was published in the journal Brain.