scholarly journals Hypoperfusion and T1-hypointense lesions in white matter in multiple sclerosis

2013 ◽  
Vol 20 (3) ◽  
pp. 365-373 ◽  
Author(s):  
Ponnada A Narayana ◽  
Yuxiang Zhou ◽  
Khader M Hasan ◽  
Sushmita Datta ◽  
Xiaojun Sun ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Arterial Spin Labeling ◽  
Healthy Controls ◽  
Resonance Imaging ◽  
Distribution Maps ◽  
T2 Lesions ◽  
Magnetic Resonance Imaging Mri ◽  
Continuous Arterial Spin Labeling ◽  
The Brain

Background: Longitudinal magnetic resonance imaging (MRI) studies show that a fraction of the multiple sclerosis (MS) T2-lesions contain T1-hypointense components that may persist to represent severe, irreversible tissue damage. It is not known why certain lesions convert to persistent T1-hypointense lesions. Objective: We hypothesized that the T1-hypointense lesions disproportionately distribute in the more hypoperfused areas of the brain. Here we investigated the association between hypoperfusion and T1-hypointense lesion distributions. Methods: MRI and cerebral blood flow (CBF) data were acquired on 45 multiple sclerosis (MS) patients and 20 healthy controls. CBF maps were generated using pseudo-continuous arterial spin labeling technique. The lesion probability distribution maps were superimposed on the CBF maps. Results: Two distinct CBF clusters were observed in the white matter (WM) both in healthy controls and MS patients. An overall reduction in CBF was observed in MS patients compared to healthy controls. The majority of the T1-hypointense lesions were concentrated almost exclusively in the WM regions with lower CBF. The T2-hyperintense lesions were more generally distributed in both higher and lower perfused WM. Conclusion: This study suggests an association between hypoperfusion and T1-hypointense lesions.

scholarly journals Cortical microinfarcts in memory clinic patients are associated with reduced cerebral perfusion

2019 ◽  
Vol 40 (9) ◽  
pp. 1869-1878 ◽  
Author(s):  
Doeschka A Ferro ◽  
Henri JJM Mutsaerts ◽  
Saima Hilal ◽  
Hugo J Kuijf ◽  
Esben T Petersen ◽  
...  
Keyword(s):  
Arterial Spin Labeling ◽  
Cerebral Perfusion ◽  
Region Of Interest ◽  
Resonance Imaging ◽  
Memory Clinic ◽  
Anterior Circulation ◽  
Cortical Gray Matter ◽  
Arterial Transit Time ◽  
Magnetic Resonance Imaging Mri ◽  
Continuous Arterial Spin Labeling

Cerebral cortical microinfarcts (CMIs) are small ischemic lesions associated with cognitive impairment and dementia. CMIs are frequently observed in cortical watershed areas suggesting that hypoperfusion contributes to their development. We investigated if presence of CMIs was related to a decrease in cerebral perfusion, globally or specifically in cortex surrounding CMIs. In 181 memory clinic patients (mean age 72 ± 9 years, 51% male), CMI presence was rated on 3-T magnetic resonance imaging (MRI). Cerebral perfusion was assessed from cortical gray matter of the anterior circulation using pseudo-continuous arterial spin labeling parameters cerebral blood flow (CBF) (perfusion in mL blood/100 g tissue/min) and spatial coefficient of variation (CoV) (reflecting arterial transit time (ATT)). Patients with CMIs had a 12% lower CBF (beta = −.20) and 22% higher spatial CoV (beta = .20) (both p < .05) without a specific regional pattern on voxel-based CBF analysis. CBF in a 2 cm region-of-interest around the CMIs did not differ from CBF in a reference zone in the contralateral hemisphere. These findings show that CMIs in memory clinic patients are primarily related to global reductions in cerebral perfusion, thus shedding new light on the etiology of vascular brain injury in dementia.

Interferon beta failure predicted by EMA criteria or isolated MRI activity in multiple sclerosis

2013 ◽  
Vol 20 (5) ◽  
pp. 566-576 ◽  
Author(s):  
Luca Prosperini ◽  
Chiara Rosa Mancinelli ◽  
Laura De Giglio ◽  
Floriana De Angelis ◽  
Valeria Barletta ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Interferon Beta ◽  
European Medicines Agency ◽  
First Year ◽  
Resonance Imaging ◽  
T2 Lesions ◽  
Increased Risk ◽  
Magnetic Resonance Imaging Mri ◽  
One Year

Objective: The objective of this paper is to investigate four-year outcomes of interferon beta (IFNB)-treated patients with multiple sclerosis (MS) according to their clinical or magnetic resonance imaging (MRI) activity status at first year of treatment. Methods: A total of 370 patients with MS duration ≤5 years before IFNB start were followed-up for four years. The optimal threshold for one-year MRI activity that more accurately predicted subsequent relapses or disability worsening was identified. The risk of relapses and disability worsening after the first year was then estimated by propensity score (PS)-adjusted analyses in patients fulfilling European Medicines Agency (EMA) criteria for second-line escalation and in those with isolated MRI activity. Results: A total of 192 (51.9%) patients relapsed, and 66 (17.8%) worsened in disability from year 1 to 4 of follow-up. The more accurate threshold for one-year MRI activity was the occurrence of ≥1 enhancing or ≥2 new T2-lesions. An increased risk of relapses and disability worsening was found in either patients fulfilling EMA criteria (hazard ratio (HR) = 3.69, and HR = 6.02) and in those experiencing isolated MRI activity (HR = 3.15, and HR = 5.31) at first year of treatment, when compared with stable patients (all p values <0.001). Conclusion: The four-year outcomes of patients with isolated MRI activity did not differ from those fulfilling EMA criteria at first year of IFNB treatment.

scholarly journals White-matter-nulled MPRAGE at 7T reveals thalamic lesions and atrophy of specific thalamic nuclei in multiple sclerosis

2019 ◽  
Vol 26 (8) ◽  
pp. 987-992 ◽  
Author(s):  
Vincent Planche ◽  
Jason H Su ◽  
Sandy Mournet ◽  
Manojkumar Saranathan ◽  
Vincent Dousset ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
White Matter ◽  
Automatic Segmentation ◽  
Resonance Imaging ◽  
Thalamic Nuclei ◽  
Individual Sequences ◽  
Weighted Magnetic Resonance Imaging ◽  
Thalamic Lesions ◽  
Magnetic Resonance Imaging Mri

Background: Investigating the degeneration of specific thalamic nuclei in multiple sclerosis (MS) remains challenging. Methods: White-matter-nulled (WMn) MPRAGE, MP-FLAIR, and standard T1-weighted magnetic resonance imaging (MRI) were performed on MS patients ( n = 15) and matched controls ( n = 12). Thalamic lesions were counted in individual sequences and lesion contrast-to-noise ratio (CNR) was measured. Volumes of 12 thalamic nuclei were measured using an automatic segmentation pipeline specifically developed for WMn-MPRAGE. Results: WMn-MPRAGE showed more thalamic MS lesions ( n = 35 in 9 out of 15 patients) than MP-FLAIR ( n = 25) and standard T1 ( n = 23), which was associated with significant improvement of CNR ( p < 0.0001). MS patients had whole thalamus atrophy ( p = 0.003) with lower volumes found for the anteroventral ( p < 0.001), the pulvinar ( p < 0.0001), and the habenular ( p = 0.004) nuclei. Conclusion: WMn-MPRAGE and automatic thalamic segmentation can highlight thalamic MS lesions and measure patterns of focal thalamic atrophy.

Application of Artificial Intelligence in Magnetic Resonance Imaging to reduce Gadolinium accumulation in patients with multiple sclerosis: A Review

2021 ◽  
Vol 1 (4) ◽  
pp. 416-428
Author(s):  
Vijay Anant Athavale ◽  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Artificial Intelligence ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Mri Scans ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain ◽  
New Onset

Gadolinium (Gd) is a based contrast agent is used for Magnetic Resonance Imaging (MRI). In India, gadobutrolhas been is approved for MRI of the Central Nervous System (CNS), liver, kidneys, and breast. It has been noted in several studies that the accumulation of gadolinium occurs in different structures in the brain. Patients with Multiple Sclerosis (MS) are regularly followed up with MRI scans and MRI with contrast enhancement is the most common method of distinguishing new-onset pathological changes. Developments in technology and methods in artificial intelligence have shown that there is reason to map out the X-ray technician’s work with examinations and medicines administered to patients may be altered to prevent the accumulation of gadolinium.

scholarly journals Concurrence of Juvenile Idiopathic Arthritis and Multiple Sclerosis

2011 ◽  
Vol 2011 ◽  
pp. 1-2
Author(s):  
Ben Abdelghani Kaouther ◽  
Souabni Leila ◽  
Belhadj Salwa ◽  
Zakraoui Leith
Keyword(s):  
Multiple Sclerosis ◽  
Juvenile Idiopathic Arthritis ◽  
Visual Evoked Potential ◽  
Evoked Potential ◽  
Brain Mri ◽  
Resonance Imaging ◽  
Cerebral Magnetic Resonance Imaging ◽  
Need To Evaluate ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

We report a 21-year-old female patient known to have Juvenile idiopathic arthritis (JIA) who later developed multiple sclerosis (MS). The disease was documented on the brain and cerebral magnetic resonance imaging (MRI) and the visual evoked potential. Our case emphasizes the need to evaluate the symptoms and brain MRI carefully. The concurrence of MS and JIA is uncommon. The possible relationship between the 2 diseases was discussed.

scholarly journals Slowly expanding/evolving lesions as a magnetic resonance imaging marker of chronic active multiple sclerosis lesions

2018 ◽  
Vol 25 (14) ◽  
pp. 1915-1925 ◽  
Author(s):  
Colm Elliott ◽  
Jerry S Wolinsky ◽  
Stephen L Hauser ◽  
Ludwig Kappos ◽  
Frederik Barkhof ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Tissue Loss ◽  
Jacobian Determinant ◽  
Resonance Imaging ◽  
T2 Lesions ◽  
Magnetic Resonance Imaging Mri

Background: Chronic lesion activity driven by smoldering inflammation is a pathological hallmark of progressive forms of multiple sclerosis (MS). Objective: To develop a method for automatic detection of slowly expanding/evolving lesions (SELs) on conventional brain magnetic resonance imaging (MRI) and characterize such SELs in primary progressive MS (PPMS) and relapsing MS (RMS) populations. Methods: We defined SELs as contiguous regions of existing T2 lesions showing local expansion assessed by the Jacobian determinant of the deformation between reference and follow-up scans. SEL candidates were assigned a heuristic score based on concentricity and constancy of change in T2- and T1-weighted MRIs. SELs were examined in 1334 RMS patients and 555 PPMS patients. Results: Compared with RMS patients, PPMS patients had higher numbers of SELs ( p = 0.002) and higher T2 volumes of SELs ( p < 0.001). SELs were devoid of gadolinium enhancement. Compared with areas of T2 lesions not classified as SEL, SELs had significantly lower T1 intensity at baseline and larger decrease in T1 intensity over time. Conclusion: We suggest that SELs reflect chronic tissue loss in the absence of ongoing acute inflammation. SELs may represent a conventional brain MRI correlate of chronic active MS lesions and a candidate biomarker for smoldering inflammation in MS.

Functional network connectivity abnormalities in multiple sclerosis: Correlations with disability and cognitive impairment

2017 ◽  
Vol 24 (4) ◽  
pp. 459-471 ◽  
Author(s):  
Maria A Rocca ◽  
Paola Valsasina ◽  
Victoria M Leavitt ◽  
Mariaemma Rodegher ◽  
Marta Radaelli ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Magnetic Resonance ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Network Connectivity ◽  
Resonance Imaging ◽  
T2 Lesions ◽  
Magnetic Resonance Imaging Mri

Objective: To investigate resting state (RS) functional connectivity (FC) abnormalities within the principal brain networks in a large cohort of multiple sclerosis (MS) patients, to define the trajectory of FC changes over disease stages and their relation with clinical and structural magnetic resonance imaging (MRI) measures. Methods: RS functional magnetic resonance imaging (fMRI), clinical, and neuropsychological evaluation were obtained from 215 MS patients and 98 healthy controls. Connectivity abnormalities and correlations with clinical/neuropsychological/imaging measures were evaluated. We analyzed seed-voxel FC with seven major hubs, producing one visual/sensory, one motor, two cognitive, one cerebellar, and two subcortical networks. Results: MS patients showed reduced network average RS FC versus controls in the default-mode network. At regional level, a complex pattern of decreased and increased RS FC was found. Reduced RS FC mainly involved sensorimotor, cognitive, thalamic, and cerebellar networks, whereas increased RS FC involved visual/sensory and subcortical networks. Reduced RS FC correlated with T2 lesions. Reduced thalamic RS FC correlated with better neuropsychological performance, whereas for all remaining networks reduced FC correlated with more severe clinical/cognitive impairment. Conclusion: Increased and decreased RS FC occurs in MS and contributes to a wide spectrum of clinical manifestations. RS FC reduction is related to T2 lesions. Such a paradigm is inverted for the thalamic network.

scholarly journals Early MRI outcomes in participants with a first clinical demyelinating event at risk of multiple sclerosis in the ORACLE-MS study

2021 ◽  
Vol 7 (1) ◽  
pp. 205521732199085
Author(s):  
Mark S Freedman ◽  
Patricia K Coyle ◽  
Giancarlo Comi ◽  
Susan L Scarberry ◽  
Doris Damian ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Resonance Imaging ◽  
Phase 3 ◽  
Post Hoc Analysis ◽  
T2 Lesions ◽  
Mri Scans ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
Post Hoc

Background In the Phase 3, 96-week ORACLE-MS study, cladribine tablets 10 mg (3.5 or 5.25 mg/kg cumulative dosage over two years) significantly reduced lesions associated with multiple sclerosis versus placebo in participants following a first clinical demyelinating event (FCDE). Objective To determine the timing of effects of cladribine tablets on lesion activity assessed by magnetic resonance imaging (MRI). Methods This post hoc analysis assessed the effect of cladribine tablets versus placebo in ORACLE-MS on secondary MRI endpoints including T1 gadolinium-enhancing (Gd+), new or enlarging T2 lesions, and combined unique active lesions assessed on MRI scans performed at screening and every 3 months thereafter. Results Compared to placebo, cladribine tablets 3.5 mg/kg treatment appeared to lead to a trend of reductions in the mean number of T1 Gd+ lesions by Week 13 (first post-baseline scan: 0.37 vs. 1.00), new or enlarging T2 (0.20 vs. 1.01) and combined unique active (0.29 vs. 1.91) lesions by Week 24. Low lesion counts were maintained with cladribine tablets throughout 96 weeks. Similar results were observed with the 5.25 mg/kg dosage. Conclusion In participants with an FCDE, cladribine tablets appeared to reduce lesion numbers within 13 weeks (time of first evaluation).

Cribriform Appearance of White Matter in Canavan Disease Associated with Novel Mutations of ASPA Gene

2021 ◽  
Author(s):  
Maya Dattatraya Bhat ◽  
Netravathi Manjunath ◽  
Renu Kumari ◽  
Mohammed Faruq ◽  
Pramod Kumar Pal ◽  
...  
Keyword(s):  
White Matter ◽  
Canavan Disease ◽  
Severe Form ◽  
Resonance Imaging ◽  
Centrum Semiovale ◽  
Novel Mutations ◽  
Rare Finding ◽  
Magnetic Resonance Imaging Mri ◽  
Intramyelinic Vacuoles ◽  
The Brain

AbstractCribriform appearance of the brain in Canavan disease is a rare finding. The two presented cases broaden the magnetic resonance imaging (MRI) phenotype wherein numerous oval, cystic structures, a few resembling dilated Virchow-Robin (VR) spaces, were noted in the centrum semiovale, periventricular, and lobar white matter producing a cribriform pattern. Besides, discrete round to oval cysts were present at the gray–white matter junctions in the second case, which were larger and appeared morphologically distinct from the VR spaces. These cysts did not elongate in any plane on imaging and were more representative of giant intramyelinic vacuoles. Genetic analysis revealed novel mutations in the aspartoacylase or ASPA gene that possibly accounts for the severe form of Canavan disease, which probably explains the imaging findings. The multicystic appearance of the white matter in Canavan disease is unusual and possibly represents two different histopathological substrates.

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