Absence Of Lesions Could Mean Fewer Multiple Sclerosis Relapses
A DGReview of :"Predictive Value of Lesions for Relapses in Relapsing-remitting Multiple Sclerosis"
American Journal of Neuroradiology
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By Veronica Rose

Researchers were unable to find any magnetic resonance markers to predict precisely an impending relapse in patients with remitting multiple sclerosis. 

However, they found an association between the absence of magnetic resonance markers and fewer relapses, indicating a more favorable outcome, according to a report from Germany.

Researchers at Heidelburg's Ruprecht-Kurls University designed a study to determine whether exacerbation of relapsing-remitting multiple sclerosis (RRMS) could be accurately predicted by enhancing lesions, new enhancing lesions and new hypo intense lesions (black holes) within a period of six months.

The study followed suggestions that enhancing lesions on contrast-enhanced Tl-weighted magnetic resonance imaging (MRI) were capable of predicting impending exacerbation in patients with RRMS.

Participants included 50 patients with RRMS, who underwent monthly MRI and clinical examinations for 12 months. Putative predictions of clinical relapses were defined from enhancing lesions, new enhancing lesions and new black hole outcomes, including a study of their operating characteristics. 

The positive predictive values for an exacerbation of enhancing lesions, new enhancing lesions or black holes did not exceed 0.25 and the negative values were all close to 0.9.

The occurrence of new enhancing lesions in each of the previous three months (PV + 0.79 [95 percent confidence interval, 0.651-0.900] PV-0.83 [95 percent CI, 0.751-0.887]) were the best predictions, while presence of new black holes in the two previous months could accurately predict new black holes (PV+ 0.54 [95 percent CI 0.372-0.697] PV -0.85 [95 percent CI 0.790-0.896]).




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