Atrophied Brain Lesion Volume: A New Imaging Biomarker in Multiple Sclerosis

2018 ◽  
Vol 28 (5) ◽  
pp. 490-495 ◽  
Author(s):  
Michael G. Dwyer ◽  
Niels Bergsland ◽  
Deepa P. Ramasamy ◽  
Dejan Jakimovski ◽  
Bianca Weinstock-Guttman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Brain Lesion ◽  
Imaging Biomarker ◽  
Lesion Volume

Relevance of hypointense brain MRI lesions for long-term worsening of clinical disability in relapsing multiple sclerosis

2013 ◽  
Vol 20 (2) ◽  
pp. 214-219 ◽  
Author(s):  
Antonio Giorgio ◽  
Maria Laura Stromillo ◽  
Maria Letizia Bartolozzi ◽  
Francesca Rossi ◽  
Marco Battaglini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Brain Mri ◽  
Univariate Analysis ◽  
Brain Lesion ◽  
Brain Magnetic Resonance Imaging ◽  
Stepwise Multiple Regression ◽  
Lesion Volume ◽  
Magnetic Resonance Imaging Mri ◽  
Relapsing Remitting Multiple Sclerosis

Background: The accrual of brain focal pathology is considered a good substrate of disability in relapsing–remitting multiple sclerosis (RRMS). However, knowledge on long-term lesion evolution and its relationship with disability progression is poor. Objective: The objective of this paper is to evaluate in RRMS the long-term clinical relevance of brain lesion evolution. Methods: In 58 RRMS patients we acquired, using the same scanner and protocol, brain magnetic resonance imaging (MRI) at baseline and 10±0.5 years later. MRI data were correlated with disability changes as measured by the Expanded Disability Status Scale (EDSS). Results: The annualized 10-year lesion volume (LV) growth was +0.25±0.5 cm3 (+6.7±8.7%) for T2-weighted (T2-W) lesions and +0.20±0.31 cm3 (+11.5±12.3%) for T1-weighted (T1-W) lesions. The univariate analysis showed moderate correlations between baseline MRI measures and EDSS at 10 years ( p < 0.001). Also, 10-year EDSS worsening correlated with LV growth and the number of new/enlarging lesions measured over the same period ( p < 0.005). In the stepwise multiple regression analysis, EDSS worsening over 10 years was best correlated with the combination of baseline T1-W lesion count and increasing T1-W LV ( R = 0.61, p < 0.001). Conclusion: In RRMS patients, long-term brain lesion accrual is associated with worsening in clinical disability. This is particularly true for hypointense, destructive lesions.

scholarly journals Incorporating Domain Knowledge Into the Fuzzy Connectedness Framework: Application to Brain Lesion Volume Estimation in Multiple Sclerosis

2007 ◽  
Vol 26 (12) ◽  
pp. 1670-1680 ◽  
Author(s):  
M.A. Horsfield ◽  
R. Bakshi ◽  
M. Rovaris ◽  
M.A. Rocca ◽  
V.S.R. Dandamudi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Domain Knowledge ◽  
Brain Lesion ◽  
Volume Estimation ◽  
Lesion Volume ◽  
Fuzzy Connectedness

Differential association of cortical, subcortical and spinal cord damage with multiple sclerosis disability milestones: A multiparametric MRI study

2021 ◽  
pp. 135245852110202
Author(s):  
Milagros Hidalgo de la Cruz ◽  
Paola Valsasina ◽  
Alessandro Meani ◽  
Antonio Gallo ◽  
Claudio Gobbi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Structural Damage ◽  
Brain Lesion ◽  
Three Dimensional ◽  
Cerebellar Atrophy ◽  
Cervical Cord ◽  
Lesion Volume ◽  
Cross Sectional ◽  
Lesion Number ◽  
Cord Lesion

Background: In multiple sclerosis (MS), cortical, subcortical and infratentorial structural damage may have a differential contribution to clinical disability according to disease phases. Purpose: To determine the relative contributions of cortical, deep (D) grey matter (GM), cerebellar and cervical cord damage to MS disability milestones. Methods: Multi-centre 3T brain and cervical cord T2- and three-dimensional (3D) T1-weighted images were acquired from 198 MS patients (139 relapsing-remitting (RR) MS, 59 progressive (P) MS) and 67 healthy controls. Brain/cord lesion burden, cortical thickness (CTh), DGM and cerebellar volumetry and cord cross-sectional area (CSA) were quantified. Random forest analyses identified predictors of expanded disability status scale (EDSS) disability milestones (EDSS = 3.0, 4.0 and 6.0). Results: MS patients had widespread atrophy in all investigated compartments versus controls ( p-range: ⩽0.001–0.05). Informative determinants of EDSS = 3.0 were cord CSA, brain lesion volume, frontal CTh and thalamic and cerebellar atrophy (out-of-bag (OOB) accuracy = 0.84, p-range: ⩽0.001–0.05). EDSS = 4.0 was mainly predicted by cerebellar and cord atrophy, frontal and sensorimotor CTh and cord lesion number (OOB accuracy = 0.84, p-range: ⩽0.001–0.04). Cervical cord CSA ( p = 0.001) and cord lesion number ( p = 0.003) predicted EDSS = 6.0 (OOB accuracy = 0.77). Conclusion: Brain lesion burden, cortical and thalamic atrophy were the main determinants of EDSS = 3.0 and 4.0, while cord damage played a major contribution to EDSS = 6.0.

Does obesity exacerbate brain lesion volume and atrophy in patients with multiple sclerosis?

2020 ◽  
Vol 46 ◽  
pp. 102502
Author(s):  
Rachel Galioto ◽  
Ophira Berenholz ◽  
Zhini Wang ◽  
Devon S. Conway ◽  
Sarah M. Planchon ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Brain Lesion ◽  
Lesion Volume

Estimating Brain Lesion Volume Change in Multiple Sclerosis by Subtraction of Magnetic Resonance Images

2016 ◽  
Vol 26 (4) ◽  
pp. 395-402 ◽  
Author(s):  
Mark A. Horsfield ◽  
Maria A. Rocca ◽  
Elisabetta Pagani ◽  
Loredana Storelli ◽  
Paolo Preziosa ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Volume Change ◽  
Brain Lesion ◽  
Magnetic Resonance Images ◽  
Lesion Volume

Expansion of chronic lesions is linked to disease progression in relapsing–remitting multiple sclerosis patients

2020 ◽  
pp. 135245852097435
Author(s):  
Samuel Klistorner ◽  
Michael H Barnett ◽  
Con Yiannikas ◽  
Joshua Barton ◽  
John Parratt ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Progression ◽  
Diffusion Tensor ◽  
Brain Lesion ◽  
Lesion Volume ◽  
Free Standing ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Multiple Sclerosis Patients ◽  
Relapsing Remitting Multiple Sclerosis

Background: Slow-burning inflammation is putatively associated with lesion expansion and leads to progressive loss of axons and disability worsening. Objective: To investigate the incidence and extent of chronic white matter lesion expansion in relapsing–remitting multiple sclerosis (RRMS) patients and to evaluate its relationship with biomarkers of disease progression. Methods: Pre- and post-gadolinium T1, fluid-attenuated inversion recovery (FLAIR) and diffusion tensor images were acquired from 33 patients. Lesional activity were analysed between baseline and 48 months using custom-designed software. Results: A total of 569 lesions were identified as chronic at baseline, of which 261 were expanding, 236 were stable and 72 were shrinking. In addition, 139 new lesions (both confluent and free-standing) were observed. Chronic lesion expansion was associated with patient’s age and accounted for the bulk (67.3%) of total brain lesion volume increase, while only 32.7% was attributable to new lesion formation. Change in chronic lesion volume correlated with the rate of brain atrophy ( r = −0.57, p = 0.001), change of Expanded Disability Status Scale (EDSS; r = 0.38, p = 0.03) and an increase of isotropic diffusivity inside the lesions ( r = 0.75, p < 0.001). Conclusion: Expansion of chronic lesions in RRMS patients is the primary determinant of increased T2 total lesion load. It significantly contributes to disease progression and partially driving axonal loss inside the lesions and brain damage outside of lesional tissue.

1H MRSI of normal appearing white matter in multiple sclerosis

1997 ◽  
Vol 3 (4) ◽  
pp. 231-237 ◽  
Author(s):  
WD Rooney ◽  
DE Goodkin ◽  
N. Schuff ◽  
DJ Meyerhoff ◽  
D. Norman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Magnetic Resonance ◽  
Proton Magnetic Resonance ◽  
Brain Lesion ◽  
Resonance Spectroscopy ◽  
Lesion Volume ◽  
Neuronal Marker ◽  
Control Subjects ◽  
Normal Appearing White Matter

The primary goal of this study was to determine if differences in proton magnetic resonance spectroscopy signals exist between normal appearing white matter (NAWM) of multiple sclerosis (MS) patients and white matter of control subjects. Water suppressed proton magnetic resonance spectroscopic imaging was used to determine the signal intensities of N-acetylated moieties (NA, predominantly N-acetylaspartate (NAA) the putative neuronal marker), creatine and phosphocreatine (Cr), and cholines (Ch) in 19 MS patients (15 relapsing-remitting and four secondary progressive) and 19 age matched control subjects. NA/Cr was significantly reduced (P < 0.00 1) in MS NAWM (1.8 ± 0.2; x ± s.d.) distant from MRI detected lesion areas compared to white matter of control subjects (2.1 ± 0.2). This reduction was due to an increase in Cr from 0.39 ± 0.04 (arbitrary units) in controls to 0.45 ± 0.05 in MS patients. There was no significant change in NA or Ch in MS NAWM compared to controls. NA/ Cr, distant from MRI lesion, was negatively correlated with total brain lesion volume as measured from T2-weighted MRI. We interpret the reduced NA/Cr in MS NAWM to indicate diffuse microscopic disease.

Design and Validation of an Expanded Disability Status Scale Model in Multiple Sclerosis

2021 ◽  
pp. 1-10
Author(s):  
Antonio Barreiro-González ◽  
Maria T. Sanz ◽  
Sara Carratalà-Boscà ◽  
Francisco Pérez-Miralles ◽  
Carmen Alcalá ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Brain Lesion ◽  
Scale Model ◽  
Lesion Volume ◽  
Expanded Disability Status Scale ◽  
Software Analysis ◽  
Disability Status ◽  
Disease Modifying

<b><i>Introduction:</i></b> We aimed to develop and validate an Expanded Disability Status Scale (EDSS) model through clinical, optical coherence tomography (OCT), and magnetic resonance imaging (MRI) measures. <b><i>Methods:</i></b> Sixty-four multiple sclerosis (MS) patients underwent peripapillary retinal nerve fiber layer and segmented macular layers evaluation through OCT (Spectralis, Heidelberg Engineering). Brain parenchymal fraction was quantified through Freesurfer, while cervical spinal cord (SC) volume was assessed manually guided by Spinal Cord Toolbox software analysis. EDSS, neuroradiological, and OCT assessment were carried out within 3 months. OCT parameters were calculated as the average of both nonoptic neuritis (ON) eyes, and in case the patient had previous ON, the value of the fellow non-ON eye was taken. Brain lesion volume, sex, age, disease duration, and history of disease-modifying treatment (1st or 2nd line disease-modifying treatments) were tested as covariables of the EDSS score. <b><i>Results:</i></b> EDSS values correlated with patient’s age (<i>r</i> = 0.543, <i>p</i> = 0.001), SC volume (<i>r</i> = −0.301, <i>p</i> = 0.034), and ganglion cell layer (GCL, <i>r</i> = −0.354, <i>p</i> = 0.012). Using these correlations, an ordinal regression model to express probability of diverse EDSS scores were designed, the highest of which was the most probable (Nagelkerke <i>R</i><sup>2</sup> = 43.3%). Using EDSS cutoff point of 4.0 in a dichotomous model, compared to a cutoff of 2.0, permits the inclusion of GCL as a disability predictor, in addition to age and SC. <b><i>Conclusions:</i></b> MS disability measured through EDSS is an age-dependent magnitude that is partly conditioned by SC and GCL. Further studies assessing paraclinical disability predictors are needed.

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