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Unraveling the neuroimaging predictors for motor dysfunction in long-standing multiple sclerosis.

Daams M, Steenwijk MD, Wattjes MP et al.

Vrije Universiteit Medical Center, Amsterdam, The Netherlands.

 Neurology 2015;85:248–55.

Cris Constantinescu’s review: The background to this study in multiple sclerosis (MS) is the well described clinical–radiological paradox of lesion volume and localization as measured on conventional magnetic resonance imaging (MRI) failing to correlate with clinical features. This paradox can partly be resolved by quantitative imaging techniques and focusing on tracts that are relevant to a specific neurological function, which has been named “importance sampling” (J Neurol Sci 2005;237:13–9).

The group at the Vrije Universiteit Medical Center (Amsterdam, the Netherlands) that performed the current large, cross-sectional study is a longstanding contributor to major advances in MS imaging. The investigators applied importance sampling and multiple parameters of MRI to a prospective cohort of 195 patients with ongoing MS that had endured for >10 years (median Expanded Disability Status Scale [EDSS] score 4) and 54 matched healthy controls to detect any association between the MRI measures and indicators of corticospinal tract (CST) dysfunction in MS.

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