“Black Holes” and Long-Term Disability in Multiple Sclerosis

In patients with multiple sclerosis (MS), T2 hyperintense brain lesions represent focal areas of inflammation, demyelination, axonal injury, and gliosis. Chronic T1 hypointense lesions are a subset of T2 lesions that represent the most severe tissue injury, with loss of axons and cellular matrix. Short-term studies have conflicted regarding the importance of these T1 hypointensities in patients with relapsing-remitting MS. Now, investigators present long-term data in a cohort with a mean 5 years' disease duration at recruitment. The same magnetic resonance imaging (MRI) scanner and sequences were used for 57 patients.

During 10 years of follow-up, the mean Expanded Disability Status Scale (EDSS) score increased from 1.8 to 2.5. Mean T2 lesio…