Predicting Disability Using Baseline and Follow-Up MRI in Multiple Sclerosis

Several studies have questioned the long-term significance of gadolinium-enhancing (GdE) and spinal cord (SC) lesions in early MS (NEJM JW Neurol Jun 2018 and Mult Scler 2018; 24:481). To further examine the associations, investigators analyzed 164 patients with clinically isolated syndrome.

Mean follow-up was 15 years. MS developed in 119 (73%): relapsing-remitting (RR) in 94 and secondary-progressive (SP) in 25. Development of SPMS was associated with ≥1 spinal cord lesion at baseline, ≥2 GdE lesions at baseline or follow-up at year 3, increasing supratentorial T2 lesions at years 1 and 3, and new infratentorial lesions at years 1 and 3. Logistic modeling confirmed that ≥2 baseline enhancing lesions and ≥1 baseline spinal cord lesions were…