The clinico-radiological paradox in multiple sclerosis revisited

摘要: The use of magnetic resonance imaging as a surrogate outcome measure in clinical trials, or even prognosticator the assessment natural evolution, assumes close relationship between extent and rate development abnormalities with status disability. While it may seem obvious that patients who develop new lesions are worse off than those without lesions, association findings radiological involvement is generally poor. In this review, various confounders discussed, including inappropriate rating, lack histopathological specificity (especially for axonal loss), neglect spinal cord involvement, underestimation damage to normal appearing brain tissue (both white gray matter), masking effects cortical adaptation. It concluded much progression has been made techniques so clinico-radiological dissociation indeed proved be paradox. Thus, relevance damage, residual volume, cerebral plasticity had reiterated. increased awareness subtle interplay these dimensions should kept mind when used measure. This corroborates conventional wisdom one not rely on single measure, but take full advantage fact able provide multidimensional information.