Mesial temporal lobe and subcortical grey matter volumes differentially predict memory across stages of multiple sclerosis

2017 ◽  
Vol 24 (5) ◽  
pp. 675-678 ◽  
Author(s):  
James F Sumowski ◽  
Victoria M Leavitt ◽  
Maria A Rocca ◽  
Matilde Inglese ◽  
Gianna Riccitelli ◽  
...  

Background/Objective: Memory deficits due to multiple sclerosis (MS) have been variably linked to lower subcortical grey matter (SCGM) and mesial temporal lobe (MTL) volumes. We investigated which is the better predictor and whether this changes across disease stages. Methods/Results: Memory was assessed in 315 patients. Magnetic resonance imaging (MRI) measured volumes of total brain, grey matter, white matter, MTL (hippocampus, amygdala) and SCGM (thalamus, caudate). MTL predicted memory in the total sample and in patients with earlier (<10 years) or later (⩾10 years) relapsing disease. SCGM (specifically thalamus) predicted memory in progressive patients. Conclusions: Neuroanatomical correlates of memory deficits differ across disease stages.

2016 ◽  
Vol 23 (3) ◽  
pp. 473-482 ◽  
Author(s):  
M Calabrese ◽  
M Castellaro ◽  
A Bertoldo ◽  
A De Luca ◽  
FB Pizzini ◽  
...  

Background: Although temporal lobe pathology may explain some of the symptoms of multiple sclerosis (MS), its role in the pathogenesis of seizures has not been clarified yet. Objectives: To investigate the role of temporal lobe damage in MS patients suffering from epilepsy, by the application of advanced multimodal 3T magnetic resonance imaging (MRI) analysis. Methods: A total of 23 relapsing remitting MS patients who had epileptic seizures (RRMS/E) and 23 disease duration matched RRMS patients without any history of seizures were enrolled. Each patient underwent advanced 3T MRI protocol specifically conceived to evaluate grey matter (GM) damage. This includes grey matter lesions (GMLs) identification, evaluation of regional cortical thickness and indices derived from the Neurite Orientation Dispersion and Density Imaging model. Results: Regional analysis revealed that in RRMS/E, the regions most affected by GMLs were the hippocampus (14.2%), the lateral temporal lobe (13.5%), the cingulate (10.0%) and the insula (8.4%). Cortical thinning and alteration of diffusion metrics were observed in several regions of temporal lobe, in insular cortex and in cingulate gyrus of RRMS/E compared to RRMS ( p< 0.05 for all comparisons). Conclusions: Compared to RRMS, RRMS/E showed more severe damage of temporal lobe, which exceeds what would be expected on the basis of the global GM damage observed.


2020 ◽  
Vol 9 (1) ◽  
pp. RD01-RD04
Author(s):  
Vishakha Mittal ◽  
Rajul Rastogi ◽  
Vijai Pratap ◽  
Satish Pathak ◽  
V.K. Singh ◽  
...  

Background: Diffusion Tensor Imaging (DTI) is a new noninvasive dimension of magnetic resonance imaging (MRI) that provides insight into the white matter microstructure. In epilepsy, widespread DTI abnormalities have been reported in multiple studies in medical literature. In mesial temporal lobe sclerosis (MTLS) patients, conventional MRI may show enlargement of ipsilateral temporal horn & reduction in volume of hippocampus in later stages of disease. However, DTI has been found to be useful in demonstrating the focus of epileptiform activity in brain especially in white matter very early in disease. Since DTI is a sensitive technique to detect subtle structural abnormalities causing epilepsy, hence it can be used to plan more successful epilepsy surgery. Therefore, we conducted a pilot study on twenty patients with seizure disorder using DTI where focal organic brain lesions were ruled-out. Aim: To assess the role of DTI in patients of MLTS with seizures.Subjects and Methods:Twenty patients with seizure disorder secondary to MLTS were evaluated using conventional MRI and DTI. We compared the final diagnosis achieved by clinical parameters correlated with EEG localization.Results:Ten out of twenty patients revealed abnormality on DTI that correlated with EEG correlation without obvious abnormality on conventional MRI representing a significant impact of DTI.Conclusion: DTI can sensitively detect structural changes in MLTS with epilepsy often undetectable on conventional MRI. Hence, DTI can serve as an important radiological tool guiding in management and presurgical evaluation of epilepsy patients considered as idiopathic or and refractory medication.


2021 ◽  
pp. 135245852110196
Author(s):  
Rosa Cortese ◽  
Marco Battaglini ◽  
Francesca Parodi ◽  
Maria Laura Stromillo ◽  
Emilio Portaccio ◽  
...  

The mechanisms responsible for the favorable clinical course in multiple sclerosis (MS) remain unclear. In this longitudinal study, we assessed whether magnetic resonance imaging (MRI)-based changes in focal and diffuse brain damage are associated with a long-term favorable MS diseases course. We found that global brain and gray matter (GM) atrophy changes were milder in MS patients with long-standing disease (⩾30 years from onset) and favorable (no/minimal disability) clinical course than in sex-age-matched disable MS patients, independently of lesions accumulation. Data showed that different trajectories of volume changes, as reflected by mild GM atrophy, may characterize patients with long-term favorable evolution.


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 3 (2) ◽  
Author(s):  
Sherif G. Nour ◽  
Jon T. Willie ◽  
Robert E. Gross

AbstractPercutaneous selective laser amygdalo-hippocampectomy (SLAH) procedure is a new minimally invasive alternative to surgical amygdalo-hippocampectomy that involves targeted, controlled laser energy deposition under real-time magnetic resonance imaging (MRI) monitoring within a dedicated “interventional MRI” suite. Technical feasibility, safety and initial efficacy results from our program are encouraging and indicate a potential for paradigm shift in future treatment of patients with exclusively or predominantly focal unilateral seizure onsets within the mesial temporal lobe. Several institutions are currently employing this technology and more long-term follow-up results on larger cohorts of patients are expected in the near future. This article reviews the principles of MRI-guided SLAH, procedure set-up and equipment, the detailed phases of intra-procedural MRI guidance and treatment monitoring, and the MRI appearance of the resultant thermal ablation zones. We conclude with a discussion of our institutional experience at Emory University with MRI-guided SLAH as one of the leading sites offering this state-of-the-art technology.


2006 ◽  
Vol 22 (4) ◽  
pp. 213-225 ◽  
Author(s):  
Kevin C. O’Connor ◽  
Sushmita Mimi Roy ◽  
Christopher H. Becker ◽  
David A. Hafler ◽  
Aaron B. Kantor

Currently, there is no single test for multiple sclerosis (MS). Diagnosis is confirmed through clinical evaluation, abnormalities revealed by magnetic resonance imaging (MRI), and analysis of cerebrospinal fluid (CSF) chemistry. The early and accurate diagnosis of the disease, monitoring of progression, and gauging of therapeutic intervention are important but elusive elements of patient care. Moreover, a deeper understanding of the disease pathology is needed, including discovery of accurate biomarkers for MS. Herein we review putative biomarkers of MS relating to neurodegeneration and contributions to neuropathology, with particular focus on autoimmunity. In addition, novel assessments of biomarkers not driven by hypotheses are discussed, featuring our application of advanced proteomics and metabolomics for comprehensive phenotyping of CSF and blood. This strategy allows comparison of component expression levels in CSF and serum between MS and control groups. Examination of these preliminary data suggests that several CSF proteins in MS are differentially expressed, and thus, represent putative biomarkers deserving of further evaluation.


2008 ◽  
Vol 14 (3) ◽  
pp. 428-430 ◽  
Author(s):  
JNP Zwemmer ◽  
JCJ Bot ◽  
B. Jelles ◽  
F. Barkhof ◽  
CH Polman

We present three patients with a clinical course and cerebrospinal fluid findings consistent with a diagnosis of primary progressive multiple sclerosis (PPMS). Extensive and repeated magnetic resonance imaging (MRI) examinations showed only diffuse abnormality in brain and spinal cord, but no focal lesions. We propose that these cases represent the most pure form of PPMS, even though according to currently applied criteria this diagnosis can not be made in the absence of focal lesions on MRI. Multiple Sclerosis 2008; 14: 428—430. http://msj.sagepub.com


2017 ◽  
Vol 01 (04) ◽  
pp. E294-E306 ◽  
Author(s):  
Mike Wattjes ◽  
Peter Raab

AbstractMagnetic resonance imaging (MRI) plays an important role in the diagnosis of multiple sclerosis and has been incorporated into the McDonald diagnostic criteria for MS. In particular, for the exclusion of important differential diagnosis and comorbidities, new MRI markers have been established such as the “central vein sign”. In addition to diagnostic purposes, the role of MRI in MS monitoring is becoming increasingly important, particularly for pharmacovigilance. This includes treatment efficacy monitoring, prediction of treatment response and safety monitoring. Quantitative MRI methods and ultra-high-field MRI offer the opportunity for the quantitative assessment of damage in normal-appearing brain tissue. However, the standardization of these techniques with the goal of implementation in clinical routine will be one of the major challenges in the near future.


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