MRI T2 lesion burden in multiple sclerosis: a plateauing relationship with clinical disability

Neurology. 2006 May 9;66(9):1384-9. doi: 10.1212/01.wnl.0000210506.00078.5c.


Background: Previous studies have shown only modest correlation between multiple sclerosis (MS) lesions on MRI and clinical disability.

Objective: To investigate the relationship between proton density/T2-weighted (T2) burden of disease (BOD) quantitatively measured on MRI scans and clinical determinants including disability.

Methods: Using the Sylvia Lawry Centre for Multiple Sclerosis Research (SLCMSR) database, the authors studied baseline T2 BOD data from a pooled subsample of 1,312 placebo MS patients from 11 randomized controlled trials. Univariate comparisons guided development of multiple regression models incorporating the most important clinical predictors.

Results: Significant, although weak to moderate, correlations were found between T2 BOD and age at disease onset, disease duration, disease course, disability (as measured by the Expanded Disability Status Scale [EDSS]), relapse rate, certain presenting symptoms, and gadolinium enhancement. An unexpected but key finding that persisted in the multiple regression analyses was a plateauing relationship between T2 BOD and disability for EDSS values above 4.5.

Conclusions: This study confirmed the limited correlation between clinical manifestations and T2 burden of disease (BOD) but revealed an important plateauing relationship between T2 BOD and disability.

MeSH terms

  • Adult
  • Age of Onset
  • Brain / pathology*
  • Databases, Factual
  • Disability Evaluation
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Multiple Sclerosis / epidemiology
  • Multiple Sclerosis / pathology*
  • Randomized Controlled Trials as Topic / statistics & numerical data
  • Severity of Illness Index