Philosophical transactions of the Royal Society of London. Series B, Biological sciences
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Philos. Trans. R. Soc. Lond., B, Biol. Sci. · Oct 1999
ReviewCharacterization of tissue damage in multiple sclerosis by nuclear magnetic resonance.
Nuclear magnetic resonance (NMR) imaging is an established diagnostic medium to diagnose multiple sclerosis (MS). In clinically stable MS patients, NMR detects silent disease activity, which is the reason why it is being used to monitor treatment trials, in which it serves as a secondary outcome parameter. The absence of a clear correlation with clinical disability, the so-called 'clinico-radiological' paradox, and the poor predictive value of NMR prohibit the use of NMR as a primary outcome parameter in clinical trials. ⋯ However, NMR provides an opportunity to sequentially measure tissue changes in vivo. Using MR parameters with (presumed) histopathological specificity, the development of (irreversible) tissue damage can be monitored, which perhaps allows the identification of factors that determine lesional outcome in MS. Since the absence of severe tissue destruction is prognostically favourable, NMR monitoring of the extent to which such changes can be prevented by treatment will ultimately benefit the selection of future treatment strategies.