Magnetic resonance active lesions as individual-level surrogate for relapses in multiple sclerosis

Background: Use of quantitative magnetic resonance imaging (MRI) metrics as surrogates for clinical outcomes in multiple sclerosis (MS) trials is controversial. Objectives: We sought to validate, at the individual-patient level, the number of MRI active lesions, as a surrogate marker for relapses in MS. Methods: Individual-patient data from two large, placebo-controlled clinical trials of subcutaneous interferon β-1a in patients with relapsing–remitting or secondary progressive (SP) MS were analysed separately and as pooled data. The four Prentice criteria were applied to assess surrogacy for the number of new T2 MRI lesions. The predictive value of short-term treatment effects on this MRI marker for longer-term clinical relapses was also assessed. Results: All Prentice criteria were satisfied. The number of new T2 MRI lesions correlated with the number of relapses over the follow-up period. The proportion of treatment effect on relapses accounted for by the effect of treatment on new T2 MRI lesions over 2 years was 53% in patients with relapsing–remitting MS, 67% in patients with secondary progressive MS, and 62% in pooled data. In the pooled data, treatment effects on new lesions over 1 year mediated a good proportion (70%) of effects on relapses over the subsequent year. Conclusions: This study provides evidence that new T2 MRI lesion count is a surrogate for relapses in patients with MS treated with interferon or drugs with a similar mechanism of action. Short-term treatment effects on this MRI measure can predict longer-term effects on relapses.

Download Full-text

Prevalence And Impact Of Myofascial Pain Syndrome In Relapsing-Remitting Multiple Sclerosis And The Effects Of Local Anesthetic Injections For Short-Term Treatment

Multiple Sclerosis and Related Disorders ◽

10.1016/j.msard.2020.102528 ◽

2020 ◽

Vol 46 ◽

pp. 102528

Author(s):

Mesude Tutuncu ◽

Devrimsel Harika Ertem ◽

Aysun Soysal

Keyword(s):

Multiple Sclerosis ◽

Local Anesthetic ◽

Myofascial Pain ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Term Treatment ◽

Short Term ◽

Short Term Treatment ◽

Relapsing Remitting ◽

Relapsing Remitting Multiple Sclerosis

Download Full-text

Short-Term Treatment with Alirocumab, Flow-Dependent Dilatation of the Brachial Artery and Use of Magnetic Resonance Diffusion Tensor Imaging to Evaluate Vascular Structure: An Exploratory Pilot Study

Biomedicines ◽

10.3390/biomedicines10010152 ◽

2022 ◽

Vol 10 (1) ◽

pp. 152

Author(s):

Thomas Metzner ◽

Deborah R. Leitner ◽

Gudrun Dimsity ◽

Felix Gunzer ◽

Peter Opriessnig ◽

...

Keyword(s):

Magnetic Resonance ◽

Fractional Anisotropy ◽

Brachial Artery ◽

Vascular Function ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Term Treatment ◽

Short Term ◽

Short Term Treatment ◽

Media Thickness

Background: Short-term effects of alirocumab on vascular function have hardly been investigated. Moreover, there is a scarce of reliable non-invasive methods to evaluate atherosclerotic changes of the vasculature. The ALIROCKS trial was performed to address these issues using standard ultrasound-based procedures and a completely novel magnetic resonance-based imaging technique. Methods: A total of 24 patients with an indication for treatment with PCSK9 antibodies were recruited. There were 2 visits to the study site, the first before initiation of treatment with alirocumab and the second after 10 weeks of treatment. The key outcome measures included the change of carotid vessel wall fractional anisotropy, a novel magnetic resonance-based measure of vascular integrity, and the changes of carotid intima-media thickness and flow-dependent dilatation of the brachial artery measured with ultrasound. Results: A total of 19 patients completed the trial, 2 patients stopped treatment, 3 patients did not undergo the second visit due to the COVID pandemic. All of them had atherosclerotic vascular disease. Their mean (standard deviation) LDL-cholesterol concentration was 154 (85) mg/dL at baseline and was reduced by 76 (44) mg/dL in response to alirocumab treatment (p < 0.001, n = 19). P-selectin and vascular endothelial growth factors remained unchanged. Flow-dependent dilatation of the brachial artery (+41%, p = 0.241, n = 18), carotid intima-media thickness (p = 0.914, n = 18), and fractional anisotropy of the carotid artery (p = 0.358, n = 13) also did not significantly change. Conclusion: Despite a nominal amelioration for flow-dependent dilatation, significant effects of short-term treatment with alirocumab on vascular function were not detectable. More work would be needed to evaluate, whether fractional anisotropy may be useful in clinical atherosclerosis research.

Download Full-text

Short-Term Treatment Effects of a Substance Use Disorder Therapy Involving Traditional Amazonian Medicine

Journal of Psychoactive Drugs ◽

10.1080/02791072.2019.1607956 ◽

2019 ◽

Vol 51 (4) ◽

pp. 323-334 ◽

Cited By ~ 3

Author(s):

Ilana Berlowitz ◽

Heinrich Walt ◽

Christian Ghasarian ◽

Fernando Mendive ◽

Chantal Martin-Soelch

Keyword(s):

Substance Use ◽

Substance Use Disorder ◽

Treatment Effects ◽

Term Treatment ◽

Short Term ◽

Short Term Treatment

Download Full-text

Short-term treatment effects produced by the Twin-block appliance: a systematic review and meta-analysis

European Journal of Orthodontics ◽

10.1093/ejo/cju030 ◽

2014 ◽

Vol 37 (2) ◽

pp. 170-176 ◽

Cited By ~ 24

Author(s):

Sayeh Ehsani ◽

Brian Nebbe ◽

David Normando ◽

Manuel O. Lagravere ◽

Carlos Flores-Mir

Keyword(s):

Systematic Review ◽

Treatment Effects ◽

Meta Analysis ◽

Term Treatment ◽

Short Term ◽

Short Term Treatment ◽

Twin Block

Download Full-text

Short-term treatment effects of quad-helix on maxillomandibular expansion in patients with maxillary incisor crowding

Odontology ◽

10.1007/s10266-011-0028-z ◽

2011 ◽

Vol 100 (1) ◽

pp. 76-86 ◽

Cited By ~ 4

Author(s):

Isao Shundo ◽

Yoshiki Kobayashi ◽

Toshiya Endo

Keyword(s):

Treatment Effects ◽

Term Treatment ◽

Maxillary Incisor ◽

Short Term ◽

Short Term Treatment ◽

Quad Helix

Download Full-text

The short-term treatment effects on the microbiota at the dorsum of the tongue in intra-oral halitosis patients—a randomized clinical trial

Clinical Oral Investigations ◽

10.1007/s00784-012-0728-y ◽

2012 ◽

Vol 17 (2) ◽

pp. 463-473 ◽

Cited By ~ 24

Author(s):

Seida Erovic Ademovski ◽

G. Rutger Persson ◽

Edwin Winkel ◽

Albert Tangerman ◽

Peter Lingström ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Treatment Effects ◽

Term Treatment ◽

Short Term ◽

Short Term Treatment

Download Full-text

Differentiation of relapsing-remitting and secondary progressive multiple sclerosis: a magnetic resonance spectroscopy study based on machine learning

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20200094 ◽

2020 ◽

Vol 78 (12) ◽

pp. 789-796

Author(s):

Ziya EKŞİ ◽

Murat ÇAKIROĞLU ◽

Cemil ÖZ ◽

Ayse ARALAŞMAK ◽

Hasan Hüseyin KARADELİ ◽

...

Keyword(s):

Machine Learning ◽

Multiple Sclerosis ◽

Magnetic Resonance ◽

Mr Spectroscopy ◽

Support Vector ◽

Resonance Spectroscopy ◽

Healthy Controls ◽

Magnetic Resonance Spectroscopy Study ◽

Secondary Progressive ◽

Relapsing Remitting

ABSTRACT Introduction: Magnetic resonance imaging (MRI) is the most important tool for diagnosis and follow-up in multiple sclerosis (MS). The discrimination of relapsing-remitting MS (RRMS) from secondary progressive MS (SPMS) is clinically difficult, and developing the proposal presented in this study would contribute to the process. Objective: This study aimed to ensure the automatic classification of healthy controls, RRMS, and SPMS by using MR spectroscopy and machine learning methods. Methods: MR spectroscopy (MRS) was performed on a total of 91 participants, distributed into healthy controls (n=30), RRMS (n=36), and SPMS (n=25). Firstly, MRS metabolites were identified using signal processing techniques. Secondly, feature extraction was performed based on MRS Spectra. N-acetylaspartate (NAA) was the most significant metabolite in differentiating MS types. Lastly, binary classifications (healthy controls-RRMS and RRMS-SPMS) were carried out according to features obtained by the Support Vector Machine algorithm. Results: RRMS cases were differentiated from healthy controls with 85% accuracy, 90.91% sensitivity, and 77.78% specificity. RRMS and SPMS were classified with 83.33% accuracy, 81.81% sensitivity, and 85.71% specificity. Conclusions: A combined analysis of MRS and computer-aided diagnosis may be useful as a complementary imaging technique to determine MS types.

Download Full-text