I have just been diagnosed as having MS. There were lesions on my scan and spinal fluid was also positive and I have been prescribed Tecfidera. Because of the lesions, should I be concerned of long term disability? Is there any correlation?
White matter brain lesions have a modest correlation to disability; however, the so called T1-black hole lesions have a stronger correlation to disability. You can ask your neurologist about that as some individuals have very low burden of this type of lesion. Other prognostic factors for disability in the future include short inter-attack interval (short time between relapses), motor/weakness attacks, spinal cord and brainstem lesions on MRI, etc.
Perhaps the most important factor for disability is a patient who is not on, or not compliant with, a disease modifying therapy when they are good candidates for treatment.
A. Scott Nielsen MD MMSc