scholarly journals Brain atrophy and clinical characteristics predicting SDMT performance in multiple sclerosis: A 10-year follow-up study

2021 ◽  
Vol 7 (1) ◽  
pp. 205521732199239
Author(s):  
Cecilie Jacobsen ◽  
Robert Zivadinov ◽  
Kjell-Morten Myhr ◽  
Turi O Dalaker ◽  
Ingvild Dalen ◽  
...  
Keyword(s):  
Clinical Data ◽  
Grey Matter Volume ◽  
Lesion Volume ◽  
Information Processing Speed ◽  
Disability Status ◽  
Mri Scans ◽  
Patients At Risk ◽  
Magnetic Resonance Imaging Mri ◽  
Specific Volumes

Objectives To identify Magnetic Resonance Imaging (MRI), clinical and demographic biomarkers predictive of worsening information processing speed (IPS) as measured by Symbol Digit Modalities Test (SDMT). Methods Demographic, clinical data and 1.5 T MRI scans were collected in 76 patients at time of inclusion, and after 5 and 10 years. Global and tissue-specific volumes were calculated at each time point. For the primary outcome of analysis, SDMT was used. Results Worsening SDMT at 5-year follow-up was predicted by baseline age, Expanded Disability Status Scale (EDSS), SDMT, whole brain volume (WBV) and T2 lesion volume (LV), explaining 30.2% of the variance of SDMT. At 10-year follow-up, age, EDSS, grey matter volume (GMV) and T1 LV explained 39.4% of the variance of SDMT change. Conclusion This longitudinal study shows that baseline MRI-markers, demographic and clinical data can help predict worsening IPS. Identification of patients at risk of IPS decline is of importance as follow-up, treatment and rehabilitation can be optimized.

Long-term course and morphological MRI correlates of cognitive function in multiple sclerosis

2020 ◽  
pp. 135245852094147 ◽  
Author(s):  
Daniela Pinter ◽  
Michael Khalil ◽  
Lukas Pirpamer ◽  
Anna Damulina ◽  
Alexander Pichler ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Neuropsychological Test ◽  
Risk Groups ◽  
Entire Group ◽  
Brain Volumes ◽  
Disability Status ◽  
Patients At Risk ◽  
Magnetic Resonance Imaging Mri

Background: Cognitive impairment frequently occurs in patients with MS (pwMS). Magnetic resonance imaging (MRI) markers could help to identify patients at risk for decline. Objective: To characterize the long-term course and morphological MRI correlates of cognitive function in pwMS. Methods: We invited 116 pwMS who had undergone clinical, cognitive, and MRI evaluations between 2006 and 2012 (baseline, BL) to attend follow-up (FU) testing between 2016 and 2018. Disability (expanded disability status scale (EDSS)), cognition (brief repeatable battery of neuropsychological test (BRB-N)), global and regional T2-lesion load (T2-LL), brain volumes, and cortical thickness were assessed. Results: Sixty-three pwMS were willing to attend the FU (54%; median EDSS = 2, interquartile range (IQR) = 2) and did not differ from non-participating pwMS regarding BL characteristics. At BL, half of the participants showed cognitive deficits in at least one domain. Across the entire group, we observed no relevant changes in physical disability and cognition over 10 years. BL thalamic volume best predicted cognitive function at FU, in addition to age and BL cognition, explaining 67% of variance. Cognitive decliners (23.8%) were older, had longer disease duration, and a tendency for lower thalamic volume at BL. Conclusion: Thalamic volume predicted FU cognitive function and distinguished declining from stable pwMS, underlining the potential of MRI to define risk groups.

scholarly journals Switching from branded to generic glatiramer acetate: 15-month GATE trial extension results

2017 ◽  
Vol 23 (14) ◽  
pp. 1909-1917 ◽  
Author(s):  
Krzysztof Selmaj ◽  
Frederik Barkhof ◽  
Anna N Belova ◽  
Christian Wolf ◽  
Evelyn RW van den Tweel ◽  
...  
Keyword(s):  
Glatiramer Acetate ◽  
Efficacy And Safety ◽  
Resonance Imaging ◽  
Open Label ◽  
Double Blind ◽  
Disability Status ◽  
Mri Scans ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri

Background: Open-label 15-month follow-up of the double-blind, placebo-controlled Glatiramer Acetate clinical Trial to assess Equivalence with Copaxone® (GATE) trial. Objective: To evaluate efficacy, safety, and tolerability of prolonged generic glatiramer acetate (GTR) treatment and to evaluate efficacy, safety, and tolerability of switching from brand glatiramer acetate (GA) to GTR treatment. Methods: A total of 729 patients received GTR 20 mg/mL daily. Safety was assessed at months 12, 15, 18, 21, and 24 and Expanded Disability Status Scale and magnetic resonance imaging (MRI) scans at months 12, 18, and 24. The presence of glatiramer anti-drug antibodies (ADAs) was tested at baseline and months 1, 3, 6, 9, 12, 18, and 24. Results: The mean number of gadolinium-enhancing lesions in the GTR/GTR and GA/GTR groups was similar at months 12, 18, and 24. The change in other MRI parameters was also similar in the GTR/GTR and GA/GTR groups. The annualized relapse rate (ARR) did not differ between the GTR/GTR and GA/GTR groups, 0.21 and 0.24, respectively. The incidence, spectrum, and severity of reported adverse events did not differ between the GTR/GTR and GA/GTR groups. Glatiramer ADA titers were similar in the GTR/GTR and GA/GTR groups. Conclusion: Efficacy and safety of GTR is maintained over 2 years. Additionally, switching from GA to GTR is safe and well tolerated.

scholarly journals Cross-sectional analysis of follow-up chest MRI and chest CT scans in patients previously affected by COVID-19

2021 ◽  
Author(s):  
Martina Pecoraro ◽  
Stefano Cipollari ◽  
Livia Marchitelli ◽  
Emanuele Messina ◽  
Maurizio Del Monte ◽  
...  
Keyword(s):  
Chest Ct ◽  
Ct Scans ◽  
Imaging Biomarker ◽  
Cross Sectional ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Sectional Analysis ◽  
Ct And Mri ◽  
Interlobular Septal Thickening

Abstract Purpose The aim of the study was to prospectively evaluate the agreement between chest magnetic resonance imaging (MRI) and computed tomography (CT) and to assess the diagnostic performance of chest MRI relative to that of CT during the follow-up of patients recovered from coronavirus disease 2019. Materials and methods Fifty-two patients underwent both follow-up chest CT and MRI scans, evaluated for ground-glass opacities (GGOs), consolidation, interlobular septal thickening, fibrosis, pleural indentation, vessel enlargement, bronchiolar ectasia, and changes compared to prior CT scans. DWI/ADC was evaluated for signal abnormalities suspicious for inflammation. Agreement between CT and MRI was assessed with Cohen’s k and weighted k. Measures of diagnostic accuracy of MRI were calculated. Results The agreement between CT and MRI was almost perfect for consolidation (k = 1.00) and change from prior CT (k = 0.857); substantial for predominant pattern (k = 0.764) and interlobular septal thickening (k = 0.734); and poor for GGOs (k = 0.339), fibrosis (k = 0.224), pleural indentation (k = 0.231), and vessel enlargement (k = 0.339). Meanwhile, the sensitivity of MRI was high for GGOs (1.00), interlobular septal thickening (1.00), and consolidation (1.00) but poor for fibrotic changes (0.18), pleural indentation (0.23), and vessel enlargement (0.50) and the specificity was overall high. DWI was positive in 46.0% of cases. Conclusions The agreement between MRI and CT was overall good. MRI was very sensitive for GGOs, consolidation and interlobular septal thickening and overall specific for most findings. DWI could be a reputable imaging biomarker of inflammatory activity.

Switching to ocrelizumab in RRMS patients at risk of PML previously treated with extended interval dosing of natalizumab

2020 ◽  
pp. 135245852094601
Author(s):  
Chiara Rosa Mancinelli ◽  
Cristina Scarpazza ◽  
Cinzia Cordioli ◽  
Nicola De Rossi ◽  
Sarah Rasia ◽  
...  
Keyword(s):  
At Risk ◽  
Resonance Imaging ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Patients At Risk ◽  
Risk Of Disease ◽  
Previously Treated ◽  
Disease Reactivation ◽  
Magnetic Resonance Imaging Mri ◽  
Relapsing Remitting Multiple Sclerosis

Discontinuation of natalizumab in patients with relapsing-remitting multiple sclerosis (RRMS) at risk of progressive multifocal leukoencephalopathy (PML) is associated with disease reactivation. Forty-two RRMS patients, who switched from an extended interval dose (EID) of natalizumab to ocrelizumab, underwent magnetic resonance imaging (MRI) and clinical monitoring during washout and after ocrelizumab starting. During the first 3 months, disease reactivation was observed in five (12%) patients; 6 months after ocrelizumab starting, no further relapses were recorded, and Expanded Disability Status Scale (EDSS) remained stable in 38 (90%) patients. In conclusion, ocrelizumab could be considered a choice to mitigate the risk of disease reactivation in patients previously treated with natalizumab-EID.

scholarly journals The long-term outcomes of CIS patients in the Barcelona inception cohort: Looking back to recognize aggressive MS

2019 ◽  
Vol 26 (13) ◽  
pp. 1658-1669 ◽  
Author(s):  
Mar Tintore ◽  
Georgina Arrambide ◽  
Susana Otero-Romero ◽  
Pere Carbonell-Mirabent ◽  
Jordi Río ◽  
...  
Keyword(s):  
Magnetic Resonance Images ◽  
Inception Cohort ◽  
Long Term Outcomes ◽  
Lesion Load ◽  
Delayed Treatment ◽  
T2 Lesions ◽  
Disability Status ◽  
Patients At Risk

Objective: To explore the long-term outcomes of patients with clinically isolated syndromes from the Barcelona cohort. Methods: We selected patients with a follow-up longer than 10 years to (1) estimate the risks of multiple sclerosis (MS) and disability accumulation according to the baseline number of T2 lesions and to compare treated versus untreated patients and early versus delayed treatment, and (2) to study baseline features of patients with aggressive MS (Expanded Disability Status Scale (EDSS) ⩾6.0 at 10 years). Results: In all, 401 patients were included (mean follow-up of 14.4 (standard deviation of 2.9) years). A higher number of T2 lesions was associated with an earlier MS diagnosis and an earlier risk of irreversible disability. Early treatment was associated with a decreased risk of EDSS of 3.0: adjusted hazard ratio = 0.4, 95% confidence interval = (0.2, 0.7). Patients with aggressive MS differed in their baseline brain magnetic resonance images: The median (interquartile range) number of T2 lesions and contrast-enhancing lesions (CEL) was 71 (28–95) versus 7 (1–19) and 3 (1–24) versus 0 (0–1), respectively. The cut-offs that better classified patients with aggressive MS were 20 for T2 lesions and 2 for CEL. Conclusion: Although MS natural history is changing, a high lesion load at onset is helpful to identify patients at risk of presenting an aggressive MS.

scholarly journals Pilomyxoid Astrocytoma: Case Report

2018 ◽  
Vol 37 (01) ◽  
pp. 54-57
Author(s):  
Renato Pignatari ◽  
Manoel Teixeira ◽  
Eberval Figueiredo
Keyword(s):  
Subtotal Resection ◽  
Thalamic Lesion ◽  
Separate Entity ◽  
Medical Assistance ◽  
Hypothalamic Area ◽  
Pilomyxoid Astrocytoma ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Immunohistochemical Studies

AbstractThe pilomyxoid astrocytoma (PMA) is a rare glioma recently described as a separate entity, which is generally located on the hypothalamic area. The PMA was previously described as pilocytic astrocytoma (PA) due to similarities shared between them. Recent studies provided a deeper understanding of PMA, setting it as a separate entity, though PMA is still considered by many authors a variant of PA. The PMA is considered to be more aggressive than PA; however, further studies are necessary for a better comprehension of its behavior and, hence, for neurosurgeons and neurologists to get to a consensus about its management.This study presents a 16-year-old female patient who looked for medical assistance complaining of headaches of over 6 months and vomiting for 2 weeks prior to the visit to the doctor. She presented no other symptoms. The physical examination displayed only bilateral papilledema. The magnetic resonance imaging (MRI) scans showed an intraventricular and thalamic lesion composed of solid and cystic material associated with peritumoral edema. The patient underwent ventriculoperitoneal shunt and subtotal resection of the lesion. The histological and immunohistochemical studies showed typical features of PMA. The patient started adjuvant therapy with chemotherapy and radiosurgery. She has been asymptomatic for 9 months and has shown no signs of progression of the disease on the follow-up scans.

Comparison of rituximab originator (MabThera®) to biosimilar (Truxima®) in patients with multiple sclerosis

2020 ◽  
pp. 135245852091217 ◽  
Author(s):  
Thomas Perez ◽  
Audrey Rico ◽  
Clémence Boutière ◽  
Adil Maarouf ◽  
Marjorie Roudot ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Adverse Events ◽  
Efficacy And Safety ◽  
Middle Income ◽  
Middle Income Countries ◽  
Disability Status ◽  
Baseline Characteristics ◽  
Magnetic Resonance Imaging Mri ◽  
Improve Access

Background: Rituximab’s originator MabThera® or Rituxan® has demonstrated high efficacy in multiple sclerosis (MS). Because of the patent expiration, rituximab biosimilars have been developed. However, because a biosimilar is not the exact copy of the originator, the efficacy and safety of a biosimilar may significantly differ. Objectives: To compare the efficacy and safety of the biosimilar Truxima® and the originator MabThera® in MS. Methods: Consecutive MS patients receiving MabThera® or Truxima® were prospectively followed during 1 year after treatment introduction. Allocation to each treatment depended on the period of introduction and not the physician’s choice. Lymphocyte count, clinical and magnetic resonance imaging (MRI) activity, Expanded Disability Status Scale (EDSS), and adverse events were compared. Results: In total, 105 and 40 patients received MabThera® and Truxima®, respectively. The two groups did not differ in baseline characteristics. Effect on CD19+ lymphocytes and disease activity were similar during follow-up. EDSS remained stable, with no difference between groups. Adverse events were similar between groups. Conclusion: The efficacy and safety of the rituximab biosimilar Truxima® seem equivalent to the originator MabThera® in MS patients. Truxima® could represent a relatively cheap and safe therapeutic alternative to MabThera® and could improve access to highly efficient therapy for MS in low- or middle-income countries.

Should frequent MRI monitoring be performed in natalizumab-treated MS patients? A contribution to a recent debate

2019 ◽  
Vol 26 (10) ◽  
pp. 1227-1236 ◽  
Author(s):  
Cristina Scarpazza ◽  
Alessio Signori ◽  
Mirco Cosottini ◽  
Maria Pia Sormani ◽  
Simonetta Gerevini ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Small Volume ◽  
Brain Magnetic Resonance Imaging ◽  
Available N ◽  
Disability Status ◽  
Mri Scans ◽  
Recent Debate ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Surveillance ◽  
The Impact

Background: Brain magnetic resonance imaging (MRI) is the most effective surveillance tool for the detection of asymptomatic progressive multifocal leukoencephalopathy (PML). However, the optimal frequency for routine MRI surveillance is under-investigated. Objective: To understand whether, upon their first MRI appearance, PML lesions present a difference in volume when comparing patients who frequently underwent MRI surveillance (3/4 months) with those who were assessed at longer intervals (6/12 months) and to understand the impact of the volume of lesions on clinical outcome. Methods: The data of patients included in the Italian PML cohort were retrospectively analysed. Patients who had all the pre-diagnostic MRI scans available ( n = 37) were included. The volume of PML lesion was calculated by manually outlining the PML lesion. Results: Compared with patients who underwent MRI examination at least every 4 months, patients who were assessed less frequently had a lesion of significantly higher volume (median: 2567 (883–3583) vs. 664 mm3 (392–963) p = 0.006) and suffered a higher rate of disability (median: 2.25 expanded disability status scale points (–2.5 to 8) vs. 0.5 (–1 to 2.5) p = 0.004). Conclusion: The positive clinical outcome of patients undergoing frequent MRI surveillance and the small volume of the PML lesion upon first appearance justify a frequent surveillance using MRI in patients at high risk of PML.

Neurologic Examination Findings Associated With Small Cerebellar Volumes After Prematurity

2019 ◽  
Vol 34 (10) ◽  
pp. 586-592
Author(s):  
Emily W.Y. Tam ◽  
Vann Chau ◽  
Raphaël Lavoie ◽  
M. Mallar Chakravarty ◽  
Ting Guo ◽  
...  
Keyword(s):  
Brain Magnetic Resonance Imaging ◽  
Postural Instability ◽  
White Matter Injury ◽  
Neurologic Examination ◽  
Equivalent Age ◽  
Cerebellar Volume ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Deformation Based Morphometry

To help clinicians understand what to expect from small cerebellar volumes after prematurity, this study aims to characterize the specific impacts of small cerebellar volumes on the infant neurologic examination. A prospective cohort of preterm newborns (<32 weeks’ gestational age) had brain magnetic resonance imaging (MRI) studies at term-equivalent age. Cerebellar volumes were compared with neurologic examination findings in follow-up, adjusting for severity of intraventricular hemorrhage, white matter injury, and cerebellar hemorrhage. Deformation-based analyses delineated regional morphometric differences in the cerebellum associated with these findings. Of 119 infants with MRI scans, 109 (92%) had follow-up at 19.0±1.7 months corrected age. Smaller cerebellar volume at term was associated with increased odds of truncal hypotonia, postural instability on standing, and patellar hyperreflexia ( P < .03). Small cerebellar volume defined as <19 cm3 by 40 weeks was associated with 7.5-fold increased odds of truncal hypotonia ( P < .001), 8.9-fold odds postural instability ( P < .001), and 9.7-fold odds of patellar hyperreflexia ( P < .001). Voxel-based deformation-based morphometry showed postural instability associated with paravermian regions. Small cerebellar volume is associated with specific abnormalities on neurologic examination by 18 months of age, including truncal tone, reflexes, and postural stability.

The contribution of assessing cognitive impairment in radiologically-isolated syndrome (RIS): a single case report follow-up study

2014 ◽  
Vol 20 (14) ◽  
pp. 1912-1915 ◽  
Author(s):  
L D’Anna ◽  
S Lorenzut ◽  
A Perelli ◽  
B Zanchettin ◽  
M Valente ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Single Case ◽  
Brain Magnetic Resonance Imaging ◽  
Single Case Report ◽  
Radiologically Isolated Syndrome ◽  
Therapeutic Decisions ◽  
Mri Scans ◽  
Incidental Discovery ◽  
Magnetic Resonance Imaging Mri

Radiologically-isolated syndrome (RIS) is a recently-defined entity, described as the incidental discovery of lesions suggestive of multiple sclerosis (MS) on brain magnetic resonance imaging (MRI) scans demonstrating dissemination in space (DIS) without symptom expression and with a normal neurological examination. Recent studies demonstrate that RIS patients present similar features of cognitive impairment as MS patients. We describe a case of a RIS patient in whom investigating cognitive functions was a useful tool for diagnostic and therapeutic decisions.

Sign in / Sign up

Export Citation Format

Share Document