A mathematically modeled, composite scale constructed from biologically meaningful MRI elements provides a reliable tool for measuring destruction of central nervous system tissue. This according to researchers who constructed the Combinatorial MRI Scale (COMRIS) based on MRI scans from 305 untreated people, with or without neurological disease. COMRIS was then validated on 114 people. Researchers found:

• COMRIS requires 5 to 10 minutes per scan on average to compute and demonstrates highly significant and validation-consistent Spearman correlation coefficients for 3 measures of neurological disability: the expanded disability status scale (EDSS), Scripps neurological rating scale (SNRS), and symbol digit modality test (SDMT).

• Because COMRIS is not greatly influenced by MRI scanners or protocols and can be computed even in the presence of some motion artifacts, it does not require censoring out patients, while providing comparable results across different cohorts.

Comment: Every case of MS is unique and appears to have some variation from another person with MS. Treatment needs vary, and examination results can vary. MRI should provide objective information, but not all MRI readers are equal, and not all MRI studies are equal. Optimal outcome measures require standardized objective information. This study provides additional information to help clinicians find a path to move forward with use of objective metrics to evaluate disease impact, disease change, and optimally, therapy efficacy. — Mark Gudesblatt, MD, Medical Director of the Comprehensive MS Care Center at South Shore Neurologic Associates in Islip, NY

Citation: Kosa P, Komori M, Waters R, et al. Novel composite MRI scale correlates highly with disability in multiple sclerosis patients. [Published online ahead of print August 25, 2015]. Mult Scler Relat Disord. doi: http://dx.doi.org/10.1016/j.msard.2015.08.009.