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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
02/26/2001
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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