A phase II trial of anti-CD4 antibodies in the treatment of multiple sclerosis

1996 ◽  
Vol 1 (6) ◽  
pp. 339-342 ◽  
Author(s):  
BW vanOosten ◽  
M Lai ◽  
F Barkhof ◽  
DH Miller ◽  
IF Moseley ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Statistical Power ◽  
Primary Outcome Measure ◽  
T Helper ◽  
Effector Cells ◽  
Natural History Studies ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain ◽  
Experimental Allergic

In multiple sclerosis (MS) myelin damage is the result of a chronic inflammatory process mediated by CD4 positive T helper/effector cells. In experimental allergic encephalomyelitis (EAE), the animal model of MS, treatment with anti-CD4 antibodies can prevent the onset of disease. Natural history studies have demonstrated that gadolinium enhanced magnetic resonance imaging (MRI) of the brain is more sensitive and objective in assessing inflammatory disease activity in MS than clinical monitoring, so that less patients and shorter studies suffice to reach the same statistical power as compared to trials using clinical outcome parameters. In this paper we describe the design of an exploratory trial of chimeric monoclonal anti-CD4 antibodies in the treatment of MS. For this study we chose the number of active MS lesions on monthly gadolinium enhanced MRI scans as the primary outcome measure.

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.

MRI Characteristic of Cerebral White Matter Maturation Patterns in Normal Infants of Assisted Reproductive

2020 ◽  
Author(s):  
Xiaoming Wu ◽  
Junfeng Wang ◽  
Libo Zou ◽  
Xiaojian Cui ◽  
Youcheng Wang ◽  
...  
Keyword(s):  
Brain Development ◽  
Cerebral White Matter ◽  
Vitro Fertilization ◽  
Brain Scans ◽  
Number Of Children ◽  
Significant Difference ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

Abstract Background Assisted reproductive technology (ART) such as in-vitro fertilization (IVF) and embryo transfer (ET) has been essential in the treatment of infertility, and the number of children born after these procedures has now passed 5 million worldwide. Children born after medically assisted reproduction are at higher risk of adverse birth outcomes than are children conceived naturally. In this study, we leveraged MRI technology to investigate whether ART pregnancy methods: intracytoplasmic sperm injection (ICSI) and ET have any effect on the brain development of offspring by comparing with the NAT pregnancy method. Methods A total of 75 infants were recruited in the study from 3 conception groups: 25 children born after ICSI, 25 children born after IVF-ET and 25 children born after natural pregnancy. Magnetic resonance imaging (MRI) scans provide exceptionally detailed information on how the human brain changes throughout childhood, adolescence, and old age. The use of MRI in the evaluation of the developing brain is well established. Results The results of routine brain scans on T1WI and T2WI showed that there was no significant difference among the 5-7, 11-13, and 23-25 months of infants among ET, ICSI, and NAT groups. The MRI values fluctuate at different time points indicating that they may change with the development of the brain. However, they are on a similar level for different conception groups supporting our previous statistical analysis that MRI values of ICSI and ET groups are not significantly different from NAT. Conclusions The results showed that there was no significant difference in brain development patterns between different modes of conception, which proved that ART does not affect the development of brain myelin in fetuses and infants.

Imaging

2017 ◽  
Author(s):  
Robert Laureno
Keyword(s):  
Resonance Imaging ◽  
Cross Sectional ◽  
Advantages And Disadvantages ◽  
Mri Scans ◽  
Cross Sectional Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Cellular Pathology ◽  
Brain And Spinal Cord ◽  
The Brain

This chapter on “Imaging” examines the relative advantages and disadvantages of computed tomography (CT) and magnetic resonance imaging (MRI) scans. It compares the modalities to each other and to gross neuropathology. For several decades, neurologists have been able to view cross-sectional images of living patients. Analogous to gross neuropathology, cross-sectional imaging displays the brain as an entire organ but does not demonstrate microscopic tissue or cellular pathology. By allowing practitioners to view sections of brain and spinal cord in vivo, imaging has improved neurologic practice and facilitated clinical research. This chapter deals with imaging topics that are important to the neurologist. The timing of scans, the effects of gravity, and the importance of plane of section are considered. Imaging is compared to gross neuropathology, and MRI is compared to CT.

Imaging primary progressive multiple sclerosis: the contribution of structural, metabolic, and functional MRI techniques

2004 ◽  
Vol 10 (3_suppl) ◽  
pp. S36-S45 ◽  
Author(s):  
Massimo Filippi ◽  
Marco Rovaris ◽  
Maria A Rocca
Keyword(s):  
Multiple Sclerosis ◽  
Functional Mri ◽  
Progressive Multiple Sclerosis ◽  
Neurological Deficits ◽  
Cervical Cord ◽  
Primary Progressive Multiple Sclerosis ◽  
Primary Progressive ◽  
Mri Scans ◽  
Functional Consequences ◽  
Magnetic Resonance Imaging Mri

Patients with primary progressive multiple sclerosis (PPMS) typically experience a progressive disease course from onset, leading to the accumulation of severe neurological disability. This is in contrast with the observation that the burden and activity of lesions on conventional magnetic resonance imaging (MRI) scans of the brain are much lower in patients with PPMS than in those with other less disabling forms of the disease. Studies with structural and functional MRI techniques are providing relevant contributions to the understanding of the mechanisms underlying the accumulatio n of irreversible neurological deficits in patients with PPMS. The results of these studies underpin that the main factors possibly explaining the clinical/MRI discrepancy observed in patients with PPMS include the presence of a diffuse tissue damage that is beyond the resolution of conventional imaging, the extent of cervical cord damage, and the impairment of the adaptive capacity of the cortex to limit the functional consequences of subcortical pathology.

Basic Neuronavigation Options for Cortical and Subcortical Brain Lesions Surgery

2018 ◽  
Vol 11 (2) ◽  
pp. 141-149
Author(s):  
Milan N. Mladenovski ◽  
Nikolay V. Vasilev ◽  
Mladen E. Ovcharov ◽  
Iliya V. Valkov
Keyword(s):  
Real Time ◽  
Brain Lesions ◽  
Neurosurgical Procedures ◽  
Cortical Lesions ◽  
Resonance Imaging ◽  
Anatomical Structures ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain ◽  
Real Time Ultrasonography

Summary Craniometric points are essential for orienting neurosurgeons in their practice. Understanding the correlations of these points help to manage any pathological lesion located on the cortical surface and subcortically. The brain sulci and gyri should be identified before craniotomy. It is difficult to identify these anatomical structures intraoperatively (after craniotomy) with precision. The main purpose of this study was to collect as much information as possible from the literature and our clinical practice in order to facilitate the placement of craniotomies without using modern neuronavigation systems. Operative reports from the last five years on cranial operations for cortical and subcortical lesions were reviewed. All the craniotomies had been planned, using four methods: detection of craniometric points, computed tomography (CT) scans/topograms, magnetic resonance imaging (MRI) scans/topograms, and intraoperative real-time ultrasonography (USG). Retrospectively, we analyzed 295 cranial operations. Our analysis showed that operating on for cortical lesions, we had frequently used the first and the second method mentioned above (118 patients), while in cases of subcortical lesions, we had used craniometric points, MRI scans/topograms and intraoperative real-time USG as methods of neuronavigation (177 patients). These results show that craniometric points are essential in both neurosurgical procedures.

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 “No evident disease activity”: The use of combined assessments in the management of patients with multiple sclerosis

2017 ◽  
Vol 23 (9) ◽  
pp. 1179-1187 ◽  
Author(s):  
Gavin Giovannoni ◽  
Davorka Tomic ◽  
Jeremy R Bright ◽  
Eva Havrdová
Keyword(s):  
Multiple Sclerosis ◽  
Disease Activity ◽  
Brain Magnetic Resonance Imaging ◽  
Individual Patient Level ◽  
Patient Reported ◽  
Magnetic Resonance Imaging Mri ◽  
The Individual ◽  
The Brain

Using combined endpoints to define no evident disease activity (NEDA) is becoming increasingly common when setting targets for treatment outcomes in multiple sclerosis (MS). Historically, NEDA has taken account of the occurrence of relapses, brain magnetic resonance imaging (MRI) lesions and disability worsening, but this approach places emphasis on inflammatory activity in the brain and mostly overlooks ongoing neurodegenerative damage. Combined assessments of NEDA which take account of changes in brain volume or neuropsychological outcomes such as cognitive function may begin to address this imbalance, and such assessments may also consider blood or spinal-fluid neurofilament levels or patient-reported outcomes and quality of life measures. If a combined NEDA assessment can be validated in prospective studies as indicative of long-term disease remission at the individual patient level, treating to achieve NEDA could become the goal of clinical practice and achieving NEDA may become the “new normal” state of disease control for patients with MS.

scholarly journals MRI in the assessment and monitoring of multiple sclerosis: an update on best practice

2017 ◽  
Vol 10 (6) ◽  
pp. 247-261 ◽  
Author(s):  
Ulrike W. Kaunzner ◽  
Susan A. Gauthier
Keyword(s):  
Multiple Sclerosis ◽  
Best Practice ◽  
High Sensitivity ◽  
The Past ◽  
Assessment And Monitoring ◽  
Magnetic Resonance Imaging Mri ◽  
Improved Technology ◽  
Brain And Spinal Cord ◽  
The Brain

Magnetic resonance imaging (MRI) has developed into the most important tool for the diagnosis and monitoring of multiple sclerosis (MS). Its high sensitivity for the evaluation of inflammatory and neurodegenerative processes in the brain and spinal cord has made it the most commonly used technique for the evaluation of patients with MS. Moreover, MRI has become a powerful tool for treatment monitoring, safety assessment as well as for the prognostication of disease progression. Clinically, the use of MRI has increased in the past couple decades as a result of improved technology and increased availability that now extends well beyond academic centers. Consequently, there are numerous studies supporting the role of MRI in the management of patients with MS. The aim of this review is to summarize the latest insights into the utility of MRI in MS.

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