By Linda Hughes
If you ask a patient with progressive multiple sclerosis to define her condition, she may say that she because of multiple sclerosis she has lost her independence, can’t work, and is getting worse.
A radiologist would see: 
- Progressive atrophy, expanding lesions
- Reduced MTR, NAA, fractional anisotropy
The neurologist would say:
- Accumulation of disability
- Gradual over time
And a pathologist would believe:
- Axonal pathology
- Oligodendrocyte pathology
At least half of all 2.3 million patients with multiple sclerosis (MS) in the world have the primary-progressive form of the disease (PPMS), but there is no FDA-approved treatment for PPMS. Nearly 10 percent of patients are diagnosed with PPMS upon onset, which is the main determinant of disability. Most MS patients begin with a relapsing form, and then develop PPMS.
Omar Khan, MD, chair and professor of neurology at Wayne State University School of Medicine in Detroit, Michigan, talked about the benefits and challenges of spinal cord MRI during a presentation at the 2015 Annual Meeting of the Consortium of Multiple Sclerosis Centers in Indianapolis, Indiana.