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  Vol. 59 No. 2, February 2002 TABLE OF CONTENTS
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Irreversible Disability and Tissue Loss in Multiple Sclerosis

A Conventional and Magnetization Transfer Magnetic Resonance Imaging Study of the Optic Nerves

Matilde Inglese, MD; Angelo Ghezzi, MD; Stefania Bianchi, MD; Simonetta Gerevini, MD; Maria Pia Sormani, PhD; Vittorio Martinelli, MD; Giancarlo Comi, MD; Massimo Filippi, MD

Arch Neurol. 2002;59:250-255.

Objectives  To assess, by magnetic resonance imaging, the volumes and magnetization transfer ratio (MTR) values of optic nerves (ONs) from patients with multiple sclerosis (MS) who had incomplete or no visual recovery after optic neuritis; and to compare these quantities with those derived from ONs from patients with MS who showed a marked clinical recovery after optic neuritis, ONs from healthy volunteers, and ONs from patients with Leber hereditary optic neuropathy (LHON).

Methods  Conventional and magnetization transfer magnetic resonance images of the ONs were obtained from 30 patients with MS, 18 healthy volunteers, and 10 patients with LHON. The ON from patients with MS were classified as clinically unaffected (n = 18); clinically affected with recovery (n = 20; visual acuity >=20/25 at least 6 months after optic neuritis); and clinically affected with incomplete or no recovery (n = 22; visual acuity <20/25 at least 6 months after optic neuritis). The ON volumes and MTR values were measured.

Results  Volumes (P = .002) and MTR values (P<.001) of the ONs from patients with MS and incomplete or no recovery were both lower than those of the ONs from patients with MS and recovery, but not different from those of the ONs from patients with LHON. Volumes and MTR values of the affected ONs from patients with MS and recovery did not differ from those of clinically unaffected ONs, which were similar to those of healthy volunteers.

Conclusion  These findings suggest that, in patients with MS, neurodegeneration is associated with persistent functional deficits secondary to incomplete recovery from relapses.


From the Neuroimaging Research Unit (Drs Inglese, Sormani, and Filippi) and Clinical Trials Unit (Drs Martinelli and Comi), Department of Neuroscience, and Departments of Ophthalmology (Dr Bianchi) and Neuroradiology (Dr Gerevini), Scientific Institute and University Ospedale San Raffaele, Milan, Italy; and Multiple Sclerosis Centre, Ospedale di Gallarate, Gallarate, Italy (Dr Ghezzi).



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