Brain, Vol 121, Issue 3 495-503, Copyright © 1998 by Oxford University Press
JI O'Riordan, AJ Thompson, DP Kingsley, DG MacManus, BE Kendall, P Rudge, WI McDonald and DH Miller
A definitive diagnosis of multiple sclerosis cannot be made at presentation
on patients with a clinically isolated syndrome of the optic nerve, spinal
cord or brainstem suggestive of demyelination, as dissemination in time is
not established. To determine the long-term risk of abnormalities on brain
MRI for the development of multiple sclerosis and disability we performed a
10-year follow-up on 81 such patients who had T2-weighted brain MRI at
presentation. Initial brain MRI was abnormal in 54 (67%). Follow up of
those patients with an abnormal MRI revealed progression to clinically
definite multiple sclerosis in 45 out of 54 (83%), of whom 11 (20%) had
relapsing/remitting disease (EDSS > 3), 13 (24%) secondary progressive
and 21 (39%) benign (relapsing/remitting with EDSS < or = 3) disease.
For those with a normal MRI progression to clinically definite multiple
sclerosis occurred in only three out of 27 (11%), all benign. There was a
significant relationship between the number of lesions at presentation and
both EDSS (r = 0.45, P < 0.001) and the type of disease at follow-up (P
< 0.0001). Brain MRI at presentation with a clinically isolated syndrome
is predictive of the long-term risk of subsequent development of multiple
sclerosis, the type of disease and extent of disability.
ARTICLES
The prognostic value of brain MRI in clinically isolated syndromes of the CNS. A 10-year follow-up
NMR Research Unit, Institute of Neurology, London, UK.
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H F McFarland, F Barkhof, J Antel, and D H Miller The role of MRI as a surrogate outcome measure in multiple sclerosis Multiple Sclerosis, February 1, 2002; 8(1): 40 - 51. [Abstract] [PDF]
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P A Brex, K A Miszkiel, J I O'Riordan, G T Plant, I F Moseley, A J Thompson, and D H Miller Assessing the risk of early multiple sclerosis in patients with clinically isolated syndromes: the role of a follow up MRI J. Neurol. Neurosurg. Psychiatry, March 1, 2001; 70(3): 390 - 393. [Abstract] [Full Text] [PDF]
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L. D. Jacobs, R. W. Beck, J. H. Simon, R. P. Kinkel, C. M. Brownscheidle, T. J. Murray, N. A. Simonian, P. J. Slasor, A. W. Sandrock, and The CHAMPS Study Group Intramuscular Interferon Beta-1A Therapy Initiated during a First Demyelinating Event in Multiple Sclerosis N. Engl. J. Med., September 28, 2000; 343(13): 898 - 904. [Abstract] [Full Text] [PDF]
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J. H. Noseworthy, C. Lucchinetti, M. Rodriguez, and B. G. Weinshenker Multiple Sclerosis N. Engl. J. Med., September 28, 2000; 343(13): 938 - 952. [Full Text] [PDF]
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A. Achiron and Y. Barak Multiple Sclerosis--From Probable to Definite Diagnosis: A 7-Year Prospective Study Arch Neurol, July 1, 2000; 57(7): 974 - 979. [Abstract] [Full Text] [PDF]
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G. Iannucci, C. Tortorella, M. Rovaris, M. P. Sormani, G. Comi, and M. Filippi Prognostic Value of MR and Magnetization Transfer Imaging Findings in Patients withClinically Isolated Syndromes Suggestive ofMultiple Sclerosis at Presentation AJNR Am. J. Neuroradiol., June 1, 2000; 21(6): 1034 - 1038. [Abstract] [Full Text]
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P. A. Brex, R. Jenkins, N. C. Fox, W. R. Crum, J. I. O'Riordan, G. T. Plant, and D. H. Miller Detection of ventricular enlargement in patients at the earliest clinical stage of MS Neurology, April 25, 2000; 54(8): 1689 - 1691. [Abstract] [Full Text] [PDF]
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M Kremenchutzky, D Lee, G P A Rice, and G C Ebers Diagnostic brain MRI findings in primary progressive multiple sclerosis Multiple Sclerosis, April 1, 2000; 6(2): 81 - 85. [Abstract] [PDF]
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M. Tintoré, A. Rovira, M. J. Martínez, J. Rio, P. Díaz-Villoslada, L. Brieva, C. Borrás, E. Grivé, J. Capellades, and X. Montalban Isolated Demyelinating Syndromes: Comparison of Different MR Imaging Criteria to Predict Conversion to Clinically Definite Multiple Sclerosis AJNR Am. J. Neuroradiol., April 1, 2000; 21(4): 702 - 706. [Abstract] [Full Text]
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J. H. Simon, R. P. Kinkel, L. Jacobs, L. Bub, and N. Simonian A Wallerian degeneration pattern in patients at risk for MS Neurology, March 14, 2000; 54(5): 1155 - 1160. [Abstract] [Full Text] [PDF]
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H F Petereit, N Richter, R Pukrop, and S Bamborschke Interferon gamma production in blood lymphocytes correlates with disability score in multiple sclerosis patients Multiple Sclerosis, February 1, 2000; 6(1): 19 - 23. [Abstract] [PDF]
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H. F. McFarland Correlation between MR and Clinical Findings of Disease Activity in Multiple Sclerosis AJNR Am. J. Neuroradiol., November 1, 1999; 20(10): 1777 - 1778. [Full Text]
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D. M. Moriarty, A. J. Blackshaw, P. R. Talbot, H. L. Griffiths, J. S. Snowden, V. F. Hillier, S. Capener, R. D. Laitt, and A. Jackson Memory Dysfunction in Multiple Sclerosis Corresponds to Juxtacortical Lesion Load on Fast Fluid-Attenuated Inversion-Recovery MR Images AJNR Am. J. Neuroradiol., November 1, 1999; 20(10): 1956 - 1962. [Abstract] [Full Text]
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P. A. Brex, J. I. O'Riordan, K. A. Miszkiel, I. F. Moseley, A. J. Thompson, G. T. Plant, and D. H. Miller Multisequence MRI in clinically isolated syndromes and the early development of MS Neurology, October 1, 1999; 53(6): 1184 - 1184. [Abstract] [Full Text] [PDF]
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W I McDonald Physicians, subsequence and consequence J. Neurol. Neurosurg. Psychiatry, September 1, 1999; 67(3): 282 - 289. [Full Text]
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 A J Larner and S F Farmer Recent advances: Neurology BMJ, August 7, 1999; 319(7206): 362 - 366. [Full Text]
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S A Hawkins and G V McDonnell Benign multiple sclerosis? Clinical course, long term follow up, and assessment of prognostic factors J. Neurol. Neurosurg. Psychiatry, August 1, 1999; 67(2): 148 - 152. [Abstract] [Full Text] [PDF]
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C Confavreux, S Vukusic, J Grimaud, and T Moreau Clinical progression and decision making process in multiple sclerosis Multiple Sclerosis, August 1, 1999; 5(4): 212 - 215. [PDF]
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F. Fazekas, F. Barkhof, M. Filippi, R. I. Grossman, D. K. B. Li, W. I. McDonald, H. F. McFarland, D. W. Paty, J. H. Simon, J. S. Wolinsky, et al. The contribution of magnetic resonance imaging to the diagnosis of multiple sclerosis Neurology, August 1, 1999; 53(3): 448 - 448. [Abstract] [Full Text] [PDF]
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M. Filippi, G. Iannucci, C. Tortorella, L. Minicucci, M. A. Horsfield, B. Colombo, M. P. Sormani, and G. Comi Comparison of MS clinical phenotypes using conventional and magnetization transfer MRI Neurology, February 1, 1999; 52(3): 588 - 588. [Abstract] [Full Text] [PDF]
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M. Sailer, J. I. O'Riordan, A. J. Thompson, D. P. Kingsley, D. G. MacManus, W. I. McDonald, and D. H. Miller Quantitative MRI in patients with clinically isolated syndromes suggestive of demyelination Neurology, February 1, 1999; 52(3): 599 - 599. [Abstract] [Full Text]
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