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Physical disability may not be directly linked to brain lesions (23/06/17)

A recent study has found that physical disability may have no link to brain lesion volume in some patients with multiple sclerosis (MS).

A clinical exam and MRI scan are the two common approaches taken by professionals to measure the severity of multiple sclerosis (MS) in a patient. Most patients show similar disease severity on both measures, but some have clinical/MRI dissociation.

Dr. Rohit Bakshi, a Neurology and Radiology Professor at Harvard Medical School launched a study, published in the Journal of Neuroimaging, to analyse why this occurs.

533 patients were selected from a comprehensive care MS centre, with concurrent brain MRI, spinal cord MRI, clinical examination and patient reported outcomes. Researchers classified patients into three groups based on the Expanded Disability Status Scale (EDSS) and cerebral T2 hyperintense lesion volume.

The first group of 22 patients had a low lesion load/high disability (LL/HD), the second group was made up of 50 patients, who had a high lesion load/low disability (HL/LD). The remaining patients were classified as not dissociated. The three groups were compared using regression techniques for unadjusted analyses and to adjust for age, disease duration, and gender.

Patients in the LL/HD group were found to be more likely to have a progressive form of MS and had significantly lower physical quality of life in adjusted and unadjusted analysis. Those in HL/LD had significantly more gadolinium-enhancing lesions, and subjects in the LL/HD group had significantly more cervical spinal cord lesions.

Commenting on the findings, Dr Bakshi said: “Our results indicate that dissociation may occur between physical disability and cerebral lesion volume in either direction in patients with MS. Type of MS, brain atrophy, and spinal cord lesions may help to bridge this dissociation.”

Source: MS-UK (23/06/17)

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