Among people whose brain scans show signs of multiple sclerosis but who have no symptoms, one-third will develop MS within about five years, researchers say.
The study included 44 people who had MRI brain scans for a variety of reasons, including migraines or head trauma. The scans detected abnormalities similar to those that occur in MS. After the researchers confirmed these abnormalities were MS-related and ruled out other causes, they followed the patients for a number of years to find out if they developed the disease.
After an average of 5.4 years, 30 percent of the patients had developed MS symptoms. Brain scans showed that another 29 percent of patients had further abnormalities but still showed no symptoms.
"More research is needed to fully understand the risk of developing MS for people with these brain abnormalities, but it appears that this condition may be a precursor to MS," study author Dr. Darin T. Okuda, of the University of California, San Francisco, Medical Center, said in an American Academy of Neurology news release.
Okuda and colleagues, who labeled this condition "radiologically isolated syndrome" (RIS), said further research is needed before any recommendations can be made regarding treatment.
The study was published online Wednesday in the journal Neurology.
In an accompanying editorial, Dr. Dennis Bourdette of the Oregon Health & Science University in Portland noted that seven of the study participants had received MS treatment before they were referred to the UCSF MS center.
"Diagnosing a patient with MS has serious psychosocial and treatment implications, and physicians have an obligation to follow appropriate criteria in making the diagnosis," Bourdette wrote. "Patients must have symptoms to receive a diagnosis. This study sets the stage for establishing a process for evaluating these patients and following them to help determine the risk of developing MS. Until then, we should not tell them that they have MS or treat them with disease-modifying therapies. For now, it's best to remember the wise advice that we treat the patient, not the MRI scan."
More information
The National Multiple Sclerosis Society has more about diagnosing MS.
SOURCE: American Academy of Neurology, news release, Dec. 10, 2008
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