Clinical-MRI correlates in multiple sclerosis (MS): Correlation of EDSS, MSFC, fatigue and depression measures with FLAIR, T1 volume and diffusion measures of normal-appearing white matter
Jones, DL and Pittas, F and Taylor, BV and McInerney, G and Rush, M, Clinical-MRI correlates in multiple sclerosis (MS): Correlation of EDSS, MSFC, fatigue and depression measures with FLAIR, T1 volume and diffusion measures of normal-appearing white matter, Internal Medicine Journal, 8-11 May, 2005, Wellington, New Zealand, pp. A64. ISSN 1444-0903 (2005) [Conference Extract]
Considering the reliance of clinicians on magnetic resonance imaging (MRI) for diagnosis and monitoring of MS clinically and in treatment trials, there is only poor correlation between MRI measures of disease burden/activity and clinical markers of disease burden/activity. Measures such as the number and volume of hyperintense T2 lesions and the degree of brain atrophy show only a relatively poor-to-modest correlation with measures of disability
such as the Expanded Disability Status Scale (EDSS). We have reassessed this relationship utilizing 28 patients with relapsing remitting MS, by: (a) breaking down MRI measures by different brain regions, (b) using multiple measures of disability and clinical status (measures including the EDSS and its subcomponents, the MS Functional Composite Score, Fatigue Severity Score and Hospital Anxiety and Depression Score) and (c) comparing more conventional measures (such as FLAIR and T1 lesion volumes with measures of normal appearing white matter via diffusion-weighted MRI). While the literature has embraced newer (and less accessible) MRI measures, our results suggest correlations are best for the more conventional FLAIR+ sequence lesion load vs EDSS, and the cerebral subcomponent of the EDSS vs FLAIR+ lesions in the periventricular, frontal and occipital regions (r = 0.64-0.71, p > 0.01).We found less convincing associations with markers of normal appearing white matter.We are currently working on regression analyses to model best fit of MRI
measures to clinical disability. These results indicate that conventional MRI measures of MS may provide useful markers of disease burden that directly correlate with the clinical
syndrome, an association that has not been found before to this degree.