Prospective combined brain and spinal cord MRI in clinically isolated syndromes and possible early multiple sclerosis: impact on dissemination in space and time

Background: Understanding long-term disability in multiple sclerosis (MS) is a key goal of research; it is relevant to how we monitor and treat the disease. Objectives: The Magnetic Imaging in MS (MAGNIMS) collaborative group sought to determine the relationship of brain lesion load, and brain and spinal cord atrophy, with physical disability in patients with long-established MS. Methods: Patients had a magnetic resonance imaging (MRI) scan of their brain and spinal cord, from which we determined brain grey (GMF) and white matter (WMF) fractional volumes, upper cervical spinal cord cross-sectional area (UCCA) and brain T2-lesion volume (T2LV). We assessed patient disability using the Expanded Disability Status Scale (EDSS). We analysed associations between EDSS and MRI measures, using two regression models (dividing cohort by EDSS into two and four sub-groups). Results: In the binary model, UCCA ( p < 0.01) and T2LV ( p = 0.02) were independently associated with the requirement of a walking aid. In the four-category model UCCA ( p < 0.01), T2LV ( p = 0.02) and GMF ( p = 0.04) were independently associated with disability. Conclusions: Long-term physical disability was independently linked with atrophy of the spinal cord and brain T2 lesion load, and less consistently, with brain grey matter atrophy. Combinations of spinal cord and brain MRI measures may be required to capture clinically-relevant information in people with MS of long disease duration.

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A Case of Acute Encephalopathy Due to Autoimmune Overload

Journal of Clinical Review & Case Reports ◽

10.33140/jcrc.05.06.07 ◽

2020 ◽

Vol 5 (6) ◽

Keyword(s):

Multiple Sclerosis ◽

Spinal Cord ◽

Pediatric Population ◽

Autoimmune Disorder ◽

Acute Disseminated Encephalomyelitis ◽

Acute Encephalopathy ◽

Demyelinating Disorder ◽

Demyelinating Disorders ◽

Brain And Spinal Cord ◽

The Brain

Acute disseminated encephalomyelitis, also known as postinfectious encephalomyelitis, is considered an autoimmune disorder that causes inflammation of the brain and spinal cord. It was seen mainly in pediatric population possibly due to vaccination but there have been cases identified in adult [1-9]. Acute disseminated encephalomyelitis can be challenging to diagnose owing to fact that there have been many overlapping symptoms among other demyelinating disorder such multiple sclerosis and Neuromyelitis Optica. In this case report, we will discuss a case about a patient that presented due to acute encephalopathy and was noted to have an atypical MRI of the brain that was not consistent with results of the lumbar puncture [10-12]. Knowledge gained from this case will help bring awareness to the diagnose of acute disseminated encephalomyelitis and how imaging in context with the clinical picture can help us differentiate between the various demyelinating disorders; thereby, giving a better understanding of managing these patients as management can affect prognosis and outcomes.

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Brain and Spinal Cord MR Imaging Features in Multiple Sclerosis and Variants

Neuroimaging Clinics of North America ◽

10.1016/j.nic.2016.12.002 ◽

2017 ◽

Vol 27 (2) ◽

pp. 205-227 ◽

Cited By ~ 11

Author(s):

Iris Dekker ◽

Mike P. Wattjes

Keyword(s):

Multiple Sclerosis ◽

Spinal Cord ◽

Mr Imaging ◽

Imaging Features ◽

Brain And Spinal Cord

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