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Understanding and preventing long-term disability in multiple sclerosis: a 14-year follow up study of patients with clinically isolated syndrome
Multiple sclerosis (MS) is a common neurological disorder in young adults. In 85% of people, MS firsts presents with an episode of inflammation affecting the nervous system called a clinically isolated syndrome (CIS). Some people with CIS stay well and do not have further attacks of inflammation, while others have further attacks (also called relapses) and are diagnosed as having relapsing-remitting MS. The prognosis of RRMS is variable. Some people remain well in the long term but permanent disability can develop either when people do not recover fully from a relapse or when the disease changes and disability slowly increases with time, referred to as secondary progressive MS. Treatments are available that reduce the number of relapses in people with relapsing MS but there are currently no available treatments for progressive forms of MS. The factors involved in the development of long term disability and the change from relapsing to progressive MS are largely unknown. This research study will help clarify these factors using new MRI techniques in a group of people who first had a CIS between 1995 and 2004 who have previously been followed up with clinical assessments and MRI. We will use new MRI techniques to better understand why some people with MS become disabled and others don't. This will help to identify new treatment strategies that have the potential to prevent long term disability. We will use the information available from previous scans to see if there are any early changes on MRI that allow us to idenitfy which patients will become disabled so we can treat this group more effectively with current and future treatments.
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