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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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Arch Neurol. 2002;59(2):321-322.
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