Early MRI predictors of prognosis in multiple sclerosis

Excerpt

Although some simple informative early clinical markers of disease course are available, individual prognosis in multiple sclerosis (MS) remains unreliable and leads to difficulties both in counseling and treatment of newly diagnosed patients. Decisions to initiate immunomodulatory treatment often depend on recent inflammatory disease activity, whereas accurate personalised long-term prognosis, which might inform both the timing and type of treatment, remains elusive. This month’s journal club reviews three studies that examine the predictive value of early MRI features in determining selective long-term outcomes such as future physical and cognitive disability and transition to secondary progressive disease phase. The use of brain imaging to visualise both cortical and chronically active ‘smouldering’ white matter lesions, may reduce the clinical-radiological paradox that has previously been described in MS. The studies outlined below explore some conventional and more novel MRI markers at baseline for their ability to predict subsequent disease progression and prognosis. …