MRI characteristics in Relapsing- Remitting versus Secondary- Progressive MS by Till Sprenger, Department of Neurology and Division of Neuroradiology University Hospital Basel, Switzerland

1. MRI characteristics in Relapsing-
Remitting versus Secondary-
Progressive MS
Till Sprenger
Department of Neurology and Division of Neuroradiology
University Hospital Basel, Switzerland

2. MRI features of different phenotypes
Filippi et al. Neurology 1999;52:588-94

3. Primary versus secondary progressive MS
Thompson et al. Ann Neurol 1991;29:53-62
Patients matched for age, sex, duration of disease and disability

4. Gadolinium enhancing lesions
Filippi et al. AJNR 1997;18:1549-1556
RRMS: Mean Age: 29; Median EDSS: 1.5
SPMS: Mean Age: 41; Median EDSS: 6.0

5. Enhancing lesions in early secondary
progressive MS
N=60
Patients studied for
4 months with
monthly scans
Average disease
duration: 12 years
Total number of
Gad+ lesions: 362
Tubridy et al. Brain 1998;121:225–231

6. Evolution of Gad+ lesions
into black holes
-48 MS patients
(35 RRMS, 8 SPMS)
-789 enhancing lesions
SPMS patients had an
odds ratio of 4.2 of
developing a black hole
over 6 months
Minnebo et al. 2005;65:56-61

7. Brain volumes in different MS phenotypes
Tedeschi et al. Neurology 2005;65:280–285
N=597 MS patients

8. Upper cervical cord area
(UCCA)
Lukas et al. Radiology 2013;269:542-552
N=440

9. Fisher et al. Ann Neurol 2008;64:255-65
Atrophy in Multiple Sclerosis

10. Whole brain atrophy in MS
De Stefano et al. Neurology 2010;74(23):1868-76

11. Spatial patterns of brain atrophy in
different MS phenotypes
SPMS
Pagani et al. AJNR 2005;26:341–346
RRMS
n=20
n=19

12. Ceccarelli et al. Neuroimage 2008
Spatial patterns of brain atrophy in
different MS phenotypes
Brain areas with volume decrease in SPMS versus RRMS
N=26 RRMS
N=27 SPMS

13. Differences between
progressive and relapsing MS
Antel et al. Acta Neuropathol 2012;123:627-638