Could MRI scans predict the disease progression of multiple sclerosis?

Written by Olivia Stevenson (Future Science Group)

Research funded by the Multiple Sclerosis (MS) Society (London, UK) has demonstrated that MRI scans of individuals who have recently been diagnosed with MS could predict the progression of the disease; understanding this could allow individuals with MS to choose the most appropriate treatment options.
In the UK, more than 100,000 individuals live with MS. Aspects of the disease such as the rapidity of progression, how disabled an individual will become, and how cognitive performance may be affected can vary enormously between individuals. Until now, it has been difficult to predict how the disease may progress after initial diagnosis.

In this study, published in Brain, 164 individuals with clinically isolated syndrome (CIS) were observed over a prolonged time period. After 15 years, the researchers utilized the Expanded Disability Status Scale to assess how the disease had progressed.

The researchers determined that initial MRI scans displayed signs of future progression. For example, early damage in the spinal cord was associated with the development of the secondary progressive form of MS, while the presence of lesions in the brain in initial MRI scans were strong indicators of an individual’s physical and cognitive performance years later.

“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,” said lead author Wallace Brownlee, UCL Institute of Neurology (London, UK).

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This information could potentially permit individuals to understand how their condition might progress, allowing them to plan for the future. Healthcare professionals would perhaps also be able to utilize this information to personalize treatment. Another recent study has suggested that initiating intensive treatment early on will lead to an improved prognosis of MS. Understanding how an individual’s disease is likely to progress could improve the effectiveness of this early intensive treatment.

“MS can be relentless, painful, and disabling, but being able to predict how a person’s MS might progress will mean more certainty, better treatment choices, and hopefully better long-term outcomes for everyone living with the condition,” concluded Brownlee.

Sources: Brownlee WJ, Altmann DR, Prados F et al. Early imaging predictors of long-term outcomes in relapse-onset multiple sclerosis. Brain doi:10.1093/brain/awz156 (2019); Multiple Sclerosis Society. MRI scans could predict multiple sclerosis (MS) disability, shows landmark 15 year study in Brain. Press release: