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Brain Scan Helps Tell the Future of MS

WebMD Health News
Reviewed by Gary D. Vogin, MD

Jan. 16, 2002 -- Being told you possibly have multiple sclerosis is very troubling. And the definite answer may take months or even years to come. But a new study shows that an MRI brain scan can give you and your doctor a good idea of what lies ahead.

It's not uncommon for someone to develop a nerve problem such as blurry vision or difficulty controlling an arm or leg. After further testing, however, some of these people are told that they possibly have multiple sclerosis. In fact, this is how the story begins in 90% of people with MS, according to lead author Peter A. Brex, MD.

His findings appear in the Jan. 17 issue of The New England Journal of Medicine,

Multiple sclerosis (MS) is thought to be an autoimmune disease, which means that your own immune system mistakenly attacks normal tissues in your body. In MS, these attacks are aimed at the brain and spinal cord, known collectively as the central nervous system.

In this new study, Brex and colleagues have found that an MRI brain scan can predict which people with potential MS symptoms probably do have the disease and will go on to develop significant disability down the road. Being able to diagnose the disease early could help doctors slow the course of the MS.

The researchers studied 71 people who had gone to the doctor with a single nerve problem that possibly indicated MS. Each person then had a series of MRI scans. The MRI scans were evaluated closely and the people were examined again about 14 years later.

Overall, definite MS developed in 68% of the people. Among the 71 people tested, 88% of those with an abnormal MRI developed full-blown MS. But only 19% of people with a normal MRI developed MS. So, the MRI was moderately effective at predicting who would and who wouldn't develop definite MS.

The researchers then looked at the amount of abnormal markings on the MRI to determine if they could predict who would develop more disability from their MS.

They found that the number of abnormalities on the initial MRI brain scan could help predict the degree of disability down the road. Those with more than 10 abnormal markings were more likely to have considerable disability in the future.

And people who developed more MRI abnormalities during the first 5 years were also more likely to have substantial disability.

Although the results indicate that MRI is useful in determining who would benefit from early MS treatment, the researchers caution that their findings show only a moderate association. Therefore, your doctor must use other criteria, such as your symptoms and how they progress, to determine the likelihood that you have MS -- and what the future may hold for you.

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