Pregnancy‐induced brain MRI changes in women with multiple sclerosis

Author(s):  
Tomas Uher ◽  
Eva Kubala Havrdova ◽  
Karolina Vodehnalova ◽  
Jan Krasensky ◽  
Vaclav Capek ◽  
...  
2008 ◽  
Vol 14 (4) ◽  
pp. 479-484 ◽  
Author(s):  
J Río ◽  
À Rovira ◽  
M Tintoré ◽  
E Huerga ◽  
C Nos ◽  
...  

Objective Our objective in this study is to evaluate whether brain magnetic resonance imaging (MRI) performed at interferon-beta (IFN-β) onset and after 12 months allow us to identify relapsing–remitting multiple sclerosis (RRMS) patients with a disability increase in the first 2 years of therapy. Methods This is a prospective and longitudinal study of patients with RRMS treated with IFN-β. All patients included underwent brain MRI before the onset of therapy with IFN-β and 12 months after. MRI measures (T2, unenhanced T1-weighted and gadolinium-enhancing T1-weighted brain lesion load, brain parenchymal fraction) were undertaken at baseline and after 12 months. The number of active lesions (new or enlarging T2 plus gadolinium-enhancing brain lesions) was also assessed on the 12 months MRI scan. Expanded Disability Status Scale (EDSS) was scored every 3 months. We defined an increase in disability as an increase of at least 1 EDSS point confirmed and sustained during the first 2 years of therapy with IFN-β. Regression analysis was performed in order to identify MRI variables of response. Results We included 152 patients who were followed-up for at least 2 years. After 2 years of therapy, 24 patients (16%) had an increase in disability. The logistic regression model showed that active lesions in the scan performed at 12 months were the most important factor related with the increase of disability after 2 years of therapy (odds ratio 8.3, 95% confidence interval 3.1–21.9; p < 0.0001). Conclusions In RRMS patients treated with IFN-β the MRI changes occurring during the first year may have a prognostic value for identifying patients with a confirmed increase of disability after 2 years of therapy.


2014 ◽  
Vol 16 (3) ◽  
pp. 111-115 ◽  
Author(s):  
Mio Nakamura ◽  
Mark Morris ◽  
Mirela Cerghet ◽  
Lonni Schultz ◽  
Stanton Elias

Background: Magnetic resonance imaging (MRI) is widely used in clinical practice, and “abnormal brain MRI” findings often prompt assessment for multiple sclerosis (MS), even when there are no symptoms suggestive of the disease. Despite several studies involving individuals with “radiologically isolated syndrome” (RIS), little is known about what factors might predict future development of MS. The objective of this study was to longitudinally evaluate clinical and MRI characteristics of people who presented to an MS clinic because of incidental abnormal MRI findings but did not have typical symptoms of MS, in order to assess risk factors for developing MS. Methods: Thirty consecutive patients presenting to an MS clinic for evaluation of abnormal MRI findings were enrolled in the study. Clinical and paraclinical data, including MRI results, were reviewed. Magnetic resonance imaging findings of T2 hyperintensities measuring more than 3 mm in diameter and fulfilling at least three out of four Barkhof criteria, with or without gadolinium-enhancing lesions, were considered to be suggestive of MS. Results: The median follow-up time was 5.5 years. No participants without MRI findings suggestive of MS were diagnosed with MS (P = .005). Fifteen participants had MRI findings suggestive of MS. Seven of the 15 (47%) were diagnosed with MS on follow-up. Cerebrospinal fluid (CSF) testing results were available for 15 participants. Abnormal results were found in six participants, of whom five (83%) also had MRI findings suggestive of MS. Only two of the nine (22%) participants with normal CSF results (P = .04) had MRI findings suggestive of MS. Conclusions: In our cohort, none of the participants without MRI findings suggestive of MS developed MS. The participants with MRI findings suggestive of MS were more likely to develop symptoms and MRI changes typical of MS on follow-up.


2010 ◽  
Vol 12 (3) ◽  
pp. 183-190 ◽  
Author(s):  
M Liguori ◽  
B C Healy ◽  
B I Glanz ◽  
S J Khoury ◽  
N Moscufo ◽  
...  

2021 ◽  
Vol 10 (4) ◽  
pp. 868
Author(s):  
Katarzyna Kapica-Topczewska ◽  
François Collin ◽  
Joanna Tarasiuk ◽  
Agata Czarnowska ◽  
Monika Chorąży ◽  
...  

The aim of the study was to verify the association of clinical relapses and brain activity with disability progression in relapsing/remitting multiple sclerosis patients receiving disease-modifying treatments in Poland. Disability progression was defined as relapse-associated worsening (RAW), progression independent of relapse activity (PIRA), and progression independent of relapses and brain MRI Activity (PIRMA). Data from the Therapeutic Program Monitoring System were analyzed. Three panels of patients were identified: R0, no relapse during treatment, and R1 and R2 with the occurrence of relapse during the first and the second year of treatment, respectively. In the R0 panel, we detected 4.6% PIRA patients at 24 months (p < 0.001, 5.0% at 36 months, 5.6% at 48 months, 6.1% at 60 months). When restricting this panel to patients without brain MRI activity, we detected 3.0% PIRMA patients at 12 months, 4.5% at 24 months, and varying from 5.3% to 6.2% between 36 and 60 months of treatment, respectively. In the R1 panel, RAW was detected in 15.6% patients at 12 months and, in the absence of further relapses, 9.7% at 24 months and 6.8% at 36 months of treatment. The R2 group was associated with RAW significantly more frequently at 24 months compared to the R1 at 12 months (20.7%; p < 0.05), but without a statistical difference later on. In our work, we confirmed that disability progression was independent of relapses and brain MRI activity.


Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1424
Author(s):  
Esben Nyborg Poulsen ◽  
Anna Olsson ◽  
Stefan Gustavsen ◽  
Annika Reynberg Langkilde ◽  
Annette Bang Oturai ◽  
...  

Spinal cord lesions are included in the diagnosis of multiple sclerosis (MS), yet spinal cord MRI is not mandatory for diagnosis according to the latest revisions of the McDonald Criteria. We investigated the distribution of spinal cord lesions in MS patients and examined how it influences the fulfillment of the 2017 McDonald Criteria. Seventy-four patients with relapsing-remitting MS were examined with brain and entire spinal cord MRI. Sixty-five patients received contrast. The number and anatomical location of MS lesions were assessed along with the Expanded Disability Status Scale (EDSS). A Chi-square test, Fischer’s exact test, and one-sided McNemar’s test were used to test distributions. MS lesions were distributed throughout the spinal cord. Diagnosis of dissemination in space (DIS) was increased from 58/74 (78.4%) to 67/74 (90.5%) when adding cervical spinal cord MRI to brain MRI alone (p = 0.004). Diagnosis of dissemination in time (DIT) was not significantly increased when adding entire spinal cord MRI to brain MRI alone (p = 0.04). There was no association between the number of spinal cord lesions and the EDSS score (p = 0.71). MS lesions are present throughout the spinal cord, and spinal cord MRI may play an important role in the diagnosis and follow-up of MS patients.


2012 ◽  
Vol 18 (11) ◽  
pp. 1585-1591 ◽  
Author(s):  
Delphine Wybrecht ◽  
Françoise Reuter ◽  
Wafaa Zaaraoui ◽  
Anthony Faivre ◽  
Lydie Crespy ◽  
...  

Background: The ability of conventional magnetic resonance imaging (MRI) to predict subsequent physical disability and cognitive deterioration after a clinically isolated syndrome (CIS) is weak. Objectives: We aimed to investigate whether conventional MRI changes over 1 year could predict cognitive and physical disability 5 years later in CIS. We performed analyses using a global approach (T2 lesion load, number of T2 lesions), but also a topographic approach. Methods: This study included 38 patients with a CIS. At inclusion, 10 out of 38 patients fulfilled the 2010 revised McDonald’s criteria for the diagnosis of multiple sclerosis. Expanded Disability Status Scale (EDSS) evaluation was performed at baseline, year 1 and year 5, and cognitive evaluation at baseline and year 5. T2-weighted MRI was performed at baseline and year 1. We used voxelwise analysis to analyse the predictive value of lesions location for subsequent disability. Results: Using the global approach, no correlation was found between MRI and clinical data. The occurrence or growth of new lesions in the brainstem was correlated with EDSS changes over the 5 years of follow-up. The occurrence or growth of new lesions in cerebellum, thalami, corpus callosum and frontal lobes over 1 year was correlated with cognitive impairment at 5 years. Conclusion: The assessment of lesion location at the first stage of multiple sclerosis may be of value to predict future clinical disability.


2014 ◽  
Vol 115 (3) ◽  
pp. 147-161 ◽  
Author(s):  
Mariano Cabezas ◽  
Arnau Oliver ◽  
Eloy Roura ◽  
Jordi Freixenet ◽  
Joan C. Vilanova ◽  
...  

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Georgios Koutsis ◽  
Georgia Karadima ◽  
Paraskewi Floroskoufi ◽  
Maria Raftopoulou ◽  
Marios Panas

We report a patient with relapsing remitting multiple sclerosis (MS) and X-linked Charcot-Marie-Tooth disease (CMTX), carrying a GJB1 mutation affecting connexin-32 (c.191G>A, p. Cys64Tyr) which was recently reported by our group. This is the third case report of a patient with CMTX developing MS, but it is unique in the fact that other family members carrying the same mutation were found to have asymptomatic central nervous system (CNS) involvement (diffuse white matter hyperintensity on brain MRI and extensor plantars). Although this may be a chance association, the increasing number of cases with CMTX and MS, especially with mutations involving the CNS, may imply some causative effect and provide insights into MS pathogenesis.


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