Background: Gadolinium (Gd) based contrast enhancement in magnetic resonance imaging (MRI) is widely used in diagnostics and follow-up of patients with MS. The contrast agents allow visualization of inflammatory changes in the central nervous system (CNS), and are helpful in detecting acute deterioration, response to treatment and disease progression on MRI. While Gd based contrast agents until recently have been considered relatively safe, there is now increasing evidence that small amounts of Gadolinium deposit in certain parts of the CNS after repeated administrations. Gd deposition may manifest as increased signal intensity on MRI. It remains unknown if Gd deposition in the CNS has clinical implications or affects the course of the disease. Objective: To investigate if the loss of function determined by a change in Extended disability status scale (EDSS) over time is greater in patients with a higher accumulation of signal intensity in the dentate nucleus (DN) on MRI. Material: The study included 36 MS patients who were followed up as outpatients at the Department of Neurology, Oslo University Hospital. The patients had undergone gadolineum based contrast agent (GBCA) enhanced MRIs, with either macrocyclic and/or linear contrast agents. The ratio between signal intensity in the DN and pons (DNP ratio) was determined on MRI on two separate timepoints, on average differed by 6 years. The signal intensity ratio was used to stratify the patients into one group with the lowest increasement in DNP ratio between the two MRIs (n=18) and another group with the highest increasement in DNP ratio between the two MRIs (n=18). Methods: Neurostatus was used to determine EDSS at two timepoints of MRI scanning in all 36 patients. The assessment was based on clinical notes from neurological examination of the patients in the outpatient clinics and/or at the submission to the Department of Neurology. The mean differences in EDSS between the two groups of patients were compared using the independent sample t-test using the SPSS software. Results: There was an overall increasement in DNP ratio in both groups of patients from the first to the last MRI. On average, the group with the lowest DNP ratios showed an increasement of 0,03 in DNP ratio (SD 0,05), whereas an average increasement of 0,13 (SD 0,03) was seen in the group with the highest increasement in DNP ratios. The corresponding increasement of mean EDSS score the same period 0.6 (SD 1,17) in the group with the lowest DNP ratio increasement and 0,5 (SD 1,15) in the group with the highest DNP ratio increasement. Thus, there was not a significant difference in increasement in EDSS btween the two groups (P =0,4). Conclusion: There was not a significant difference in loss of function between patients with high and patients with low accumulation of signal intensity in DN on MRI over a period of time.