Relapsing-remitting multiple sclerosis: longitudinal analysis of MR images--lack of correlation between changes in T2 lesion volume and clinical findings.

Abstract

To determine the relationship between T2 lesion volume and either disability measurements or change in T2 lesion volume over time in multiple sclerosis (MS). Eighteen patients (age range, 26-53 years) with clinically proved relapsing-remitting MS were examined every 6 months for over 2 years. Three-millimeter-thick contiguous images of the whole brain were obtained. T2 lesion volume was calculated with a highly reproducible volumetric computer method. A substantial annual increase in T2 lesion volume, with a median annual increase of approximately 8%, was demonstrated. However, there was no significant correlation between absolute T2 lesion volume and either the absolute expanded disability status scale (EDSS) grade (P = .32) or the absolute ambulation index (AI) (P = .20). In addition, no significant correlation between change in T2 lesion volume and change in EDSS grade (P = .42) or AI (P = .37) was found. There was no significant correlation between T2 lesion volume and duration of disease (P = .08). There is no significant correlation between T2 lesion volume and standardized disability measurements despite a substantial increase in T2 lesion volume over time. Patients have an increase in total T2 lesion volume in the brain regardless of their clinical status or disability measurements. T2 lesion volumes as outcomes in therapeutic clinical trials on MS should be viewed as secondary outcomes rather than as surrogate markers of clinical responses.