MRI characteristics in Relapsing-Remitting versus Secondary-

Progressive MS

Till Sprenger Department of Neurology and Division of Neuroradiology

University Hospital Basel, Switzerland

MRI features of different phenotypes

Filippi et al. Neurology 1999;52:588-94

Primary versus secondary progressive MS

Thompson et al. Ann Neurol 1991;29:53-62

Patients matched for age, sex, duration of disease and disability

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

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

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

Brain volumes in different MS phenotypes

Tedeschi et al. Neurology 2005;65:280–285

N=597 MS patients

Upper cervical cord area (UCCA)

Lukas et al. Radiology 2013;269:542-552

N=440

Fisher et al. Ann Neurol 2008;64:255-65

Atrophy in Multiple Sclerosis

Whole brain atrophy in MS

De Stefano et al. Neurology 2010;74(23):1868-76

Spatial patterns of brain atrophy in different MS phenotypes

SPMS

Pagani et al. AJNR 2005;26:341–346

RRMS

n=20

n=19

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

Differences between progressive and relapsing MS

Antel et al. Acta Neuropathol 2012;123:627-638