Quality of Life and Its Relationship to Brain Lesions and Atrophy on Magnetic Resonance Images in 60 Patients With Multiple Sclerosis

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Abstract
PHYSICAL DISABILITY assessment using the Expanded Disability Status Scale (EDSS) is currently considered to be the most useful clinical measure of multiple sclerosis (MS) disease activity and is the primary clinical outcome measure in most MS clinical trials.1 However, EDSS is heavily influenced by limb and gait dysfunction2 and may have low sensitivity in detecting other important clinical deficits caused by MS of the brain, such as fatigue, depression, and sexual and cognitive dysfunction.3 This low sensitivity may partly explain the poor relationship between the assessment of the clinical status of patients using EDSS and the disease burden using conventional brain magnetic resonance imaging (MRI).4 Hence, there is a need for more sensitive clinical outcome measures that assess the clinical consequences of brain lesions caused by MS.5 Quality of life (QOL) scales are comprehensive clinical measures that assess several important domains of health from a patient's perspective and have the potential for being useful clinical outcome measures in the short-term evaluation of disease-modifying drug therapies.6 However, the effect of MS on various aspects of QOL and the relationship between increasing neurologic disability and pathologic brain alterations and impaired QOL are still not clearly understood.

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