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Old 04-13-2014, 02:52 PM #1
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Originally Posted by tkrik View Post
I tend to think its all a crapshoot whether or not one will progress and if the DMDs are really working. No one can really give you a definite answer either. And, lesion load doesn't equate to disability either. It's such an individual thing and each of us is different with the same label - MS.

I have not been on a DMD for a few years now. I don't notice a difference other than i am not have severe allergic reactions from taking C. My rate of flares hasn't changed either. I'm still averaging 2 a year. Of those flares, I still have the same amount of lesions. It's the same lesions causing me trouble over and over.
Tricia, I totally agree with you. It's a crapshoot. And lesion load surely does not equate to disability.

I'm sure any imaging center will be happy to let patients have as many MRI's as they are willing to pay for. Unfortunately, MRI's simply cannot tell you how disabled you will become based on lesion load.

LillyMS, I'm sorry you feel that I'm irresponsible and foolish not to put more weight in my MRIs but I've had MS for years and so far the MRI has not matched the level of disability I have (or had).
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Old 04-13-2014, 03:02 PM #2
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Ya, I'm fully aware of how some pople can have only one or two lesions but are in a wheelchair. Whereas on the other hand, people like me who have horrible volume lesions are fine.. for now at least. It really is crazy when you think about it.

I know the analogy you could use is: Someone shooting a gun in a dark room and if the bullet hits the light switch that controls the light in the room... then that room is screwed!

Still, I feel like a ticking time bomb with so many lesions. One neuro said I'm on the verge of serious problems if I don't get on MS drug and that "the only reason I'm doing so well is because I'm young". I don't believe that for one second. I'm not even that young anymore.
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Old 04-13-2014, 03:10 PM #3
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The radiologist wrote the following my my MRI report:

“extensive white matter disease suprantentorially as well as along the brain stem and cerebellar peduncles."

All I have to say is I don't like the word EXTENSIVE or any of the other words in that sentence! I'm a bit freaked out to say the least. That is saying I've got disease several places in the brain, not good.
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Old 04-13-2014, 03:51 PM #4
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Take a look at my attached MRI report. As you can see my MS progressed SEVERELY. I have a TON of lesions. This MRI was done couple years ago, since then it's been stable... but look at how AWFUL my MRI is. The radiologist forced me to see the neuro right away immediately after he removed me from the MRI machine. He wouldn't allow me to go home. I didn't even have appointment with neuro that day! Luckily, neuro was in same building.

I really feel like I'm screwed. I feel like a ticking time bomb. Don't know what else to say. Anyone else here have scans this bad? I was symptomatic, yet look how bad my MRI scan results were. Yet as you know, some people with only one lesion can be in wheel chair. This is crazy stuff!
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Old 04-13-2014, 06:15 PM #5
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My research indicates that a high lesion load is a strong indicator of future long term disability. There may be other factors such as DMD drugs that could alter this outcome.

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Quote:
J Neurol Neurosurg Psychiatry. 2013 Oct;84(10):1082-91. doi: 10.1136/jnnp-2012-304094. Epub 2013 Mar 23.

Brain atrophy and lesion load predict long term disability in multiple sclerosis.

Popescu V1, Agosta F, Hulst HE, Sluimer IC, Knol DL, Sormani MP, Enzinger C, Ropele S, Alonso J, Sastre-Garriga J, Rovira A, Montalban X, Bodini B, Ciccarelli O, Khaleeli Z, Chard DT, Matthews L, Palace J, Giorgio A, De Stefano N, Eisele P, Gass A, Polman CH, Uitdehaag BM, Messina MJ, Comi G, Filippi M, Barkhof F, Vrenken H; MAGNIMS Study Group.

OBJECTIVE
To determine whether brain atrophy and lesion volumes predict subsequent 10 year clinical evolution in multiple sclerosis (MS).

DESIGN:
From eight MAGNIMS (MAGNetic resonance Imaging in MS) centres, we retrospectively included 261 MS patients with MR imaging at baseline and after 1-2 years, and Expanded Disability Status Scale (EDSS) scoring at baseline and after 10 years. Annualised whole brain atrophy, central brain atrophy rates and T2 lesion volumes were calculated. Patients were categorised by baseline diagnosis as primary progressive MS (n=77), clinically isolated syndromes (n=18), relapsing-remitting MS (n=97) and secondary progressive MS (n=69). Relapse onset patients were classified as minimally impaired (EDSS=0-3.5, n=111) or moderately impaired (EDSS=4-6, n=55) according to their baseline disability (and regardless of disease type). Linear regression models tested whether whole brain and central atrophy, lesion volumes at baseline, follow-up and lesion volume change predicted 10 year EDSS and MS Severity Scale scores.

RESULTS:

In the whole patient group, whole brain and central atrophy predicted EDSS at 10 years, corrected for imaging protocol, baseline EDSS and disease modifying treatment. The combined model with central atrophy and lesion volume change as MRI predictors predicted 10 year EDSS with R(2)=0.74 in the whole group and R(2)=0.72 in the relapse onset group. In subgroups, central atrophy was predictive in the minimally impaired relapse onset patients (R(2)=0.68), lesion volumes in moderately impaired relapse onset patients (R(2)=0.21) and whole brain atrophy in primary progressive MS (R(2)=0.34).

CONCLUSIONS:

This large multicentre study points to the complementary predictive value of atrophy and lesion volumes for predicting long term disability in MS.


KEYWORDS:

MRI, MULTIPLE SCLEROSIS


PMID: 23524331 [PubMed - indexed for MEDLINE]
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Old 04-13-2014, 06:26 PM #6
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I am totally screwed. I am only 34 yrs old (very athletic female... run 3 miles every day on my thread mill etc) and should enjoy the days I have left. I got MS in 2002... it is now 2014... even though my MRIs look TERRIBLE I am still doing way better than 99% of others with MS because I feel completely normal as if I didn't even have MS. Unfortunately, I doubt this will last!

I will not be taking any MS drugs. Just giving LDN a try and getting MRIs every 6 months. If new lesions start to form I will then get back tecfidera as my last resort. Have to give LDN a shot first.

EDIT: For those participating in this thread... do you have anywhere near the volume of lesions I have? I am seriously freaking out here. This is not good
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Old 04-13-2014, 06:44 PM #7
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This is really confusing. I think I just found a contradictive article here:

https://www.facebook.com/notes/ccsvi...51429538792211

Note: I merely glanced at this article (don't have time to read it now), so hope I'm not wrong.
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