MS progression is difficult to predict as the disease manifests itself differently in every patient. In their study recently published in Brain, the researchers ventured out to define the predictors of long-term disability outcomes by using clinically isolated syndrome (CIS), a first episode of neurological symptoms that can evolve into MS, as a baseline. They used MRI exams after a CIS diagnosis to anticipate the future of a patient’s health and determine the severity of a person’s MS.
Initially, the researchers had 166 patients with a CIS diagnosis but no other history of neurological conditions undergo a MRI scan of their brain and spinal cord. The scans were performed three months after their CIS diagnosis, and then 135 of those patients underwent a second scan after 12 months, and three years later, 121 of those patients had a third scan. The participants were continuously evaluated for around 15 years.
Their 15-year evaluation showed that 72 percent of patients developed MS. Out of that group, 94 of those patients were diagnosed with relapsing-remitting MS (RRMS) and 25 had secondary progressive MS (SPMS). Forty-five patients still had their CIS diagnosis, and two patients had developed other conditions.
“At baseline, the patients who developed secondary progressive multiple sclerosis at 15 years had a higher median number of spinal cord lesions (1 versus 0), compared with patients who remained relapsing-remitting multiple sclerosis,” wrote the researchers. They also found that the MRI brain and spinal cord scans showed that SPMS patients had “a higher median number of new spinal cord lesions compared with those with RRMS at 15 years.”