Efficacy for symptoms vs. Lesion load?

[Spydre]

Okay, I'm getting ready to switch from Copaxone to Tysabri. This decision was made after an MRI in February (after my first flare in over a year) showed 4 new lesions, I had the flare, and then I had another flare in May, 4 months later. We did a 6 month MRI, and this time I only have one new lesion, and another is bigger. I know lesion load doesn't necessarily correlate to how you are feeling, but now I'm wondering...well, we are making the switch, based on the frequency of the flares, and the new symptoms.

I guess my question is, can I be getting worse with flares and symptoms, but not really getting much worse in regards to lesion load? This is the only MRI that I've ever had that has shown only one new lesion - usually there are several new lesions.

[WACVet]

I don't know about others, but I've gotten worse, and my lesion load has not really increased... I had one lesion get a little bigger. Of course, I have no idea about anything in the spine yet, as I'm scheduled for my first torso MRI in Sept. All I know is, I've gotten worse in the past year, and only 2 lesions showed up (same two in the previous MRI).

I'd love to hear from some others about this.

[hackwriter]

Location, location, location...

I have a relatively light lesion load and always have, but my disability level went from 2 to 6 on the EDSS over a period of several years.

The location of your lesions has everything to do with what kind of symptoms you experience. If you have 10 little lesions in the periventricular white brain matter, these could be completely asymptomatic. But, two lesions in the cervical spine can cause bladder dysfunction, ataxia, foot drop, weak legs, and lots of other trouble besides.

The burning question I have these days is: What value does an MRI have after the diagnostic phase is over? I'm sure it has some, but I need a reminder about what that might be.

Kim

[cosake]

One reason to use MRI after diagnosis is to track lesions and see if any DMD that you are taking is working.

Another, is if you opt to not use a DMD, to track if you have new lesions that may make you change your mind about a DMD. (This is what happened to me).