2005 issue 1

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Volume 14, issue 1

Original article

Correlation between motor disability and MRI brain scans in patients with sclerosis multiplex

Renata Poniatowska1, Jerzy Kulczycki2, Wanda Sobczyk2, RENATA KRAWCZYK1, ROMANA BOGUSŁAWSKA1
1. Zakład Neuroradiologii Instytutu Psychiatrii i Neurologii w Warszawie
2. I Klinika Neurologii Instytutu Psychiatrii i Neurologii w Warszawie
Postępy Psychiatrii i Neurologii 2005; 14 (1): 19-24
Keywords: magnetic resonance, multiple sclerosis, relapsing-remitting MS, primary-progressive MS, secondary-progressive MS, Kurtzke EDSS scale
Abstract

Objectives. The Magnetic Resonance Imaging (MRI) examination shows white matter abnormalities, and allows assessing the localisation, number, and volume of lesions. The aim of the study was to find correlation between clinical symptomatology ofpatients with multiple sclerosis (MS) and demyelinisation lesions in their MRI brain scans.

Methods. In 31 MS patients disability was assessed using the Kurtzke EDSS. The number, volume and localisation of demyelinisation lesions in MRI were assessed in the standard planes, using SE and FSE sequences. Relationship was analysed between the white matter demyelinisation lesions and various MS phenotypes, the disease duration, and EDSS scores.

Results. On the basis of their MRI brain scans the patients were divided into 2 subgroups: with either distinctive multiple foci or diffuse lesions (N = 12 and 19, respectively). In the multiple foci group 10 patients were diagnosed with the relapsing-remitting MS, and 2 with the primary-progressive MS, which was recognised also in 9 cases in the diffuse lesions group. The volume of lesions turned out to be 7.5 times smaller in patients with multiplefoci than in those with diffuse lesions. The disease duration was almost twice as long in the latter patients, who demonstrated also a more marked disability.

Conclusions. The lesion volume was found to correlate positively both with EDSS scores and the disease duration. The patients from the diffuse lesions group were more disabled than those with multiple foci. The total volume of lesions was larger in patients with the secondary-progressive MSphenotype than in those with relapsing-remitting MS. Diagnostic difficulties in some cases of primary progressive MS were due to an atypical onset of the disease presenting as mental disorders.

Address for correspondence:
Dr Renata Poniatowska, Zakład Neuroradiologii Instytutu Psychiatrii i Neurologii, ul. Sobieskiego 9,
02-957 Warszawa, e-mail:poniatow@ipin.edu.pl