Diagnostic brain MRI findings in primary progressive multiple sclerosis.

The clinical course of multiple sclerosis can be classified as relapsing from onset (relapsing-remitting), or progressive from onset (primary progressive - PPMS). These clinical phenotypes have been based on historical and clinical observations. It has been reported that PPMS patients tend to have q...

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Main Authors: Kremenchutzky, M, Lee, D, Rice, G, Ebers, G
Format: Journal article
Language:English
Published: 2000
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author Kremenchutzky, M
Lee, D
Rice, G
Ebers, G
author_facet Kremenchutzky, M
Lee, D
Rice, G
Ebers, G
author_sort Kremenchutzky, M
collection OXFORD
description The clinical course of multiple sclerosis can be classified as relapsing from onset (relapsing-remitting), or progressive from onset (primary progressive - PPMS). These clinical phenotypes have been based on historical and clinical observations. It has been reported that PPMS patients tend to have quantitatively less MRI activity and disease burden. We evaluated the sensitivity and diagnostic value of conventional brain MRI scan in 143 PPMS patients. Brain MRIs were blindly evaluated to determine if they satisfied Paty and/or Fazekas diagnostic criteria. Patients were divided into those with typical, atypical or normal scans. They satisfied brain MRI criteria in 92% cases. Findings included: 131 typical, four atypical, and eight normal scans. All 12 non-typical scans' subjects had spinal onset; spinal MRI scans were positive in four of seven cases. Sex, age of onset, site and number of symptoms involved at onset among those groups were not significantly different but accumulation of disability had a tendency to be slower in these few individuals with normal or atypical head MRI's. Although there may be quantitative differences in lesion activity/burden, MRI scanning in PPMS unexpectedly has diagnostic sensitivity very similar to that seen in RRMS. A normal brain MRI is unusual in PPMS patients.
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spelling oxford-uuid:70bf35cd-22f4-4e51-91e6-62574e1404612022-03-26T19:39:10ZDiagnostic brain MRI findings in primary progressive multiple sclerosis.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:70bf35cd-22f4-4e51-91e6-62574e140461EnglishSymplectic Elements at Oxford2000Kremenchutzky, MLee, DRice, GEbers, GThe clinical course of multiple sclerosis can be classified as relapsing from onset (relapsing-remitting), or progressive from onset (primary progressive - PPMS). These clinical phenotypes have been based on historical and clinical observations. It has been reported that PPMS patients tend to have quantitatively less MRI activity and disease burden. We evaluated the sensitivity and diagnostic value of conventional brain MRI scan in 143 PPMS patients. Brain MRIs were blindly evaluated to determine if they satisfied Paty and/or Fazekas diagnostic criteria. Patients were divided into those with typical, atypical or normal scans. They satisfied brain MRI criteria in 92% cases. Findings included: 131 typical, four atypical, and eight normal scans. All 12 non-typical scans' subjects had spinal onset; spinal MRI scans were positive in four of seven cases. Sex, age of onset, site and number of symptoms involved at onset among those groups were not significantly different but accumulation of disability had a tendency to be slower in these few individuals with normal or atypical head MRI's. Although there may be quantitative differences in lesion activity/burden, MRI scanning in PPMS unexpectedly has diagnostic sensitivity very similar to that seen in RRMS. A normal brain MRI is unusual in PPMS patients.
spellingShingle Kremenchutzky, M
Lee, D
Rice, G
Ebers, G
Diagnostic brain MRI findings in primary progressive multiple sclerosis.
title Diagnostic brain MRI findings in primary progressive multiple sclerosis.
title_full Diagnostic brain MRI findings in primary progressive multiple sclerosis.
title_fullStr Diagnostic brain MRI findings in primary progressive multiple sclerosis.
title_full_unstemmed Diagnostic brain MRI findings in primary progressive multiple sclerosis.
title_short Diagnostic brain MRI findings in primary progressive multiple sclerosis.
title_sort diagnostic brain mri findings in primary progressive multiple sclerosis
work_keys_str_mv AT kremenchutzkym diagnosticbrainmrifindingsinprimaryprogressivemultiplesclerosis
AT leed diagnosticbrainmrifindingsinprimaryprogressivemultiplesclerosis
AT riceg diagnosticbrainmrifindingsinprimaryprogressivemultiplesclerosis
AT ebersg diagnosticbrainmrifindingsinprimaryprogressivemultiplesclerosis