Incidence of interattack asymptomatic brain lesions in NMO spectrum disorder

Neurology ◽  
2020 ◽  
Vol 95 (23) ◽  
pp. e3124-e3128
Author(s):  
Min Young Lee ◽  
Kok Pin Yong ◽  
Jae-Won Hyun ◽  
Su-Hyun Kim ◽  
Sang-Hyun Lee ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Brain Mri ◽  
Brain Lesion ◽  
Brain Lesions ◽  
Spectrum Disorder ◽  
Cancer Center ◽  
Conventional Mri ◽  
Monitoring Strategies ◽  
Mri Scans ◽  
Aqp4 Antibody

ObjectiveTo determine whether aquaporin-4 (AQP4) antibody–seropositive patients with neuromyelitis optica spectrum disorder (NMOSD) develop new asymptomatic brain lesions during the interattack period.MethodsOf 296 consecutive AQP4 antibody–seropositive patients in the NMOSD database of the National Cancer Center from May 2005 to November 2019, 145 patients, who had serial brain MRI scans over an interval of at least 1 year during relapse-free period after immunosuppressive therapy, with 370 longitudinally assessed brain MRI scans were included in this study. We retrospectively analyzed them for presence of new subclinical brain lesions during the relapse-free period.ResultsFive of 145 patients (3.4%) had detectable new, asymptomatic brain lesions in the deep white matter over a total observed relapse-free period of 708 person-years. All the lesions were smaller than 6 mm and assessed to be nonspecific. No brain lesion characteristic of NMOSD or gadolinium-enhancing lesion was identified.ConclusionsAsymptomatic brain lesions are rarely observed on conventional MRI in clinically stable AQP4 antibody–seropositive patients with NMOSD after immunosuppressive therapy and brain MRI lesions characteristic of NMOSD are not seen in the relapse-free period. These findings may provide further insight regarding currently known diagnostic and disease-monitoring strategies in NMOSD.

scholarly journals Risk factors for hip dislocation in dyskinetic cerebral palsy

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902110011
Author(s):  
Kyoko Okuno ◽  
Yukihiro Kitai ◽  
Toru Shibata ◽  
Hiroshi Arai
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Birth Weight ◽  
Gestational Age ◽  
Brain Mri ◽  
Brain Lesion ◽  
Brain Lesions ◽  
Lesion Location ◽  
Hip Displacement ◽  
Gmfcs Level

Purpose: To investigate the risk factors for hip displacement in patients with dyskinetic cerebral palsy (DCP). Methods: We evaluated 81 patients with DCP, 45 males and 36 females, aged 10–22 years, risk factors for hip displacement were evaluated using multivariate logistic regression analysis with primary brain lesions, Gross Motor Function Classification System (GMFCS) level, gestational age, birth weight, Cobb’s angle, and complication of epilepsy as independent factors. Hip displacement was defined as migration percentage >30%. Primary brain lesions were classified into globus pallidus (GP), thalamus and putamen (TP), and others using brain magnetic resonance imaging (MRI). Perinatal and clinical features were compared between patients with GP lesions and those with TP lesions. Results: Hip displacement was observed in 53 patients (67%). Higher GMFCS levels (p = 0.013, odds ratio [OR] 2.6) and the presence of GP lesions (p = 0.04, OR 16.5) were independent risk factors for hip displacement. Patients with GP lesions showed significantly higher GMFCS levels, more frequent hip displacement, and lower gestational age and birth weight than those with TP lesions. Conclusion: Primary brain lesion location may be an important factor in predicting hip displacement among patients with DCP. Appropriate risk assessment using brain MRI may contribute to the early detection and intervention of hip displacement because brain lesion location can be assessed during infancy before GMFCS level is decided.

Accuracy of magnetic resonance spectroscopy in discrimination of neoplastic and non-neoplastic brain lesions

2021 ◽  
Vol 17 ◽  
Author(s):  
Qurain T Alshammari ◽  
Mohammed Salih ◽  
Moawia Gameraddin ◽  
Bushra Abdel Malik ◽  
Mohamed Yousef ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Brain Lesion ◽  
Brain Lesions ◽  
Resonance Spectroscopy ◽  
Histopathological Analysis ◽  
Cross Sectional ◽  
Conventional Mri ◽  
Single Voxel ◽  
Histopathologic Analysis ◽  
Good Agreement

Background: Differentiation of brain lesions by conventional MRI alone is not enough. The introduction of sophisticated imaging methods, such as MR spectroscopy (MRS), will have considered contribution and accuracy to the differentiation. Objective: To determine the diagnostic accuracy of MRS in differentiating neoplasm and non-neoplastic brain lesion. Methodology: This is a cross-sectional descriptive study conducted at Khartoum State from the period of 2015 to 2017. Thirty cases with brain lesions were included in the study investigated with MRS (Single-voxel spectroscopy) and conventional MRI. A comparison of MRS findings and histopathologic analysis was performed. The ratios of Cho/Cr and Cho/NAA were analyzed and compared between neoplastic and non-neoplastic brain masses. Data were analyzed using SPSS version 23. Results: Out of the 30 patients affected with brain lesions, there were 16 females and 14 males with a mean age of 44 +- 18 years. The ratios of Cho/Cr and Cho/NAA were higher in gliomas, astrocytoma, and meningioma than non-neoplastic lesions. Kappa statistical value (K) showed a good agreement between MRS and histopathological analysis (K= 0.60). The diagnostic accuracy of MRS was 100%, with 82.60% sensitivity, 85.71% specificity, 95% PPV, and 60% NPV. Conclusion: MRS has high diagnostic accuracy in differentiating neoplasm from non-neoplastic brain tumors. The elevation ratios of Choline-to- N-acetyl aspartate and choline-to- creatine can help Neurosurgeons and clinicians differentiate benign from malignant masses.

THE USEFULNESS OF T2 RELAXOMETRY IN DIFFERENTIATING INFECTIVE FROM NEOPLASTIC RIM ENHANCING BRAIN LESIONS: EARLY EXPERIENCE

2015 ◽  
Vol 77 (6) ◽  
Author(s):  
Mohammad Hanafiah ◽  
Sharis Osman Syazarina ◽  
Hanafiah Hazlenah ◽  
Azura Muhamed Mukari Shahizon
Keyword(s):  
Brain Lesion ◽  
Relaxation Times ◽  
Early Experience ◽  
Brain Lesions ◽  
T2 Relaxation ◽  
T2 Relaxometry ◽  
Quantitative Mr ◽  
Conventional Mri ◽  
Mri Sequences ◽  
Age Range

Characterizing a rim enhancing brain lesion remains a challenge and conventional MRI sequences may not be adequate. The aim of our study was to determine whether or not rim enhancing brain lesions of infective origin could be differentiated from neoplasm using MR T2 relaxometry. T2 relaxation times were measured in the central core of 29 rim-enhancing lesions from 23 patients. (10 female, 13 male, age range 12-73 years old). The mean T2 relaxation time of infective lesions was 194.6ms (range 89.5- 498.7ms; SD 144.8) and that of tumour was 893.7 ms (range 147.8-1540.0 ms; SD 431.5). Our early experience showed that T2 relaxometry is a potential quantitative MR technique that can differentiate infective from neoplastic rim enhancing brain lesions.

Development of extensive brain lesions following fingolimod (FTY720) treatment in a patient with neuromyelitis optica spectrum disorder

2011 ◽  
Vol 18 (1) ◽  
pp. 113-115 ◽  
Author(s):  
Ju-Hong Min ◽  
Byoung Joon Kim ◽  
Kwang Ho Lee
Keyword(s):  
Neuromyelitis Optica ◽  
Vasogenic Edema ◽  
Brain Mri ◽  
Brain Lesions ◽  
Steroid Treatment ◽  
Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Parietal Lobes ◽  
The Right ◽  
The Brain

We report the case of a patient who developed extensive brain lesions during fingolimod (FTY720) treatment in the TRANSFORMS study. His initial diagnosis was multiple sclerosis, but after encephalopathy anti-aquaporin4 antibody (anti-AQP4 Ab) was detected, it was changed to neuromyelitis optica spectrum disorder. After treatment with fingolimod, he developed bilateral extensive brain lesions. The brain MRI showed lesions predominantly involving the right frontal and parietal lobes, with vasogenic edema and enhancement. He had residual encephalomalacia and no recurrence with steroid treatment over 3 years following withdrawal of fingolimod.

scholarly journals Brain Magnetic Resonance Findings in 117 Children with Autism Spectrum Disorder under 5 Years Old

2020 ◽  
Vol 10 (10) ◽  
pp. 741
Author(s):  
Magali Jane Rochat ◽  
Giacomo Distefano ◽  
Monica Maffei ◽  
Francesco Toni ◽  
Annio Posar ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Magnetic Resonance ◽  
Brain Mri ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Mri Findings ◽  
Children With Asd ◽  
Routine Magnetic Resonance Imaging ◽  
Eeg Abnormalities ◽  
Mri Scans

We examined the potential benefits of neuroimaging measurements across the first 5 years of life in detecting early comorbid or etiological signs of autism spectrum disorder (ASD). In particular, we analyzed the prevalence of neuroradiologic findings in routine magnetic resonance imaging (MRI) scans of a group of 117 ASD children younger than 5 years old. These data were compared to those reported in typically developing (TD) children. MRI findings in children with ASD were analyzed in relation to their cognitive level, severity of autistic symptoms, and the presence of electroencephalogram (EEG) abnormalities. The MRI was rated abnormal in 55% of children with ASD with a significant prevalence in the high-functioning subgroup compared to TD children. We report significant incidental findings of mega cisterna magna, ventricular anomalies and abnormal white matter signal intensity in ASD without significant associations between these MRI findings and EEG features. Based on these results we discuss the role that brain MRI may play in the diagnostic procedure of ASD.

The influence of slice orientation on brain MRI lesion load measurement in multiple sclerosis

1997 ◽  
Vol 3 (6) ◽  
pp. 382-384
Author(s):  
M. Rovaris ◽  
MP Sormanis ◽  
MA Rocca ◽  
G. Comi ◽  
M. Filippi
Keyword(s):  
Multiple Sclerosis ◽  
Spin Echo ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Lesion Load ◽  
Conventional Mri ◽  
Slice Orientation ◽  
Mri Scans ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri

This study aimed at evaluating the influence of a different slice orientation on brain magnetic resonance imaging (MRI) lesion load in multiple sclerosis (MS). Fifteen MS patients were scanned obtaining both axial and sagittal conventional spin echo (24 slices; TR 2400, TE 30/80) brain MRI. The total lesion load (TLL) was assessed twice for each scan, using a semi-automated local thresholding technique and the same marked hardcopies. The mean TLL was 22734 mm3 for axial and 22003 mm3 for sagittal scans. The mean intra-observer coefficient of variation (COV) was 4.65% for the axial acquisitions and 4.52% for the sagittal acquisitions. This difference was not statistically significant (one-way ANOVA, P> 0.1). The lesion load was significantly higher from axial MRI as compared to the intra-observer variability (two-way ANOVA, P =0.01), but the fluctuations around this average difference between axial and sagittal scan TLL were significantly large (test for interaction, P < 0.00I). Our data indicate that the use of sagittal conventional MRI scans does not seem to be worthwhile for the quantitative assessment of lesion load in MS patients.

scholarly journals MRI Patterns Distinguish AQP4 Antibody Positive Neuromyelitis Optica Spectrum Disorder From Multiple Sclerosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Laura Clarke ◽  
Simon Arnett ◽  
Wajih Bukhari ◽  
Elham Khalilidehkordi ◽  
Sofia Jimenez Sanchez ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Neuromyelitis Optica ◽  
Predictive Models ◽  
Nucleus Tractus Solitarius ◽  
Brain Lesions ◽  
Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Imaging Data ◽  
Mri Features ◽  
Aqp4 Antibody

Neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) are inflammatory diseases of the CNS. Overlap in the clinical and MRI features of NMOSD and MS means that distinguishing these conditions can be difficult. With the aim of evaluating the diagnostic utility of MRI features in distinguishing NMOSD from MS, we have conducted a cross-sectional analysis of imaging data and developed predictive models to distinguish the two conditions. NMOSD and MS MRI lesions were identified and defined through a literature search. Aquaporin-4 (AQP4) antibody positive NMOSD cases and age- and sex-matched MS cases were collected. MRI of orbits, brain and spine were reported by at least two blinded reviewers. MRI brain or spine was available for 166/168 (99%) of cases. Longitudinally extensive (OR = 203), “bright spotty” (OR = 93.8), whole (axial; OR = 57.8) or gadolinium (Gd) enhancing (OR = 28.6) spinal cord lesions, bilateral (OR = 31.3) or Gd-enhancing (OR = 15.4) optic nerve lesions, and nucleus tractus solitarius (OR = 19.2), periaqueductal (OR = 16.8) or hypothalamic (OR = 7.2) brain lesions were associated with NMOSD. Ovoid (OR = 0.029), Dawson's fingers (OR = 0.031), pyramidal corpus callosum (OR = 0.058), periventricular (OR = 0.136), temporal lobe (OR = 0.137) and T1 black holes (OR = 0.154) brain lesions were associated with MS. A score-based algorithm and a decision tree determined by machine learning accurately predicted more than 85% of both diagnoses using first available imaging alone. We have confirmed NMOSD and MS specific MRI features and combined these in predictive models that can accurately identify more than 85% of cases as either AQP4 seropositive NMOSD or MS.

Neuromyelitis optica spectrum disorder mimicking extensive leukodystrophy

2018 ◽  
Vol 24 (9) ◽  
pp. 1256-1258 ◽  
Author(s):  
Jonathan Ciron ◽  
Olivier Colin ◽  
Marie-Pierre Rosier ◽  
Soline Lapeyrie ◽  
Damien Biotti ◽  
...  
Keyword(s):  
White Matter ◽  
Neuromyelitis Optica ◽  
Brain Mri ◽  
White Matter Lesions ◽  
Brain Lesions ◽  
Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorders ◽  
Spectrum Disorders

Brain MRI was originally considered to appear normal in neuromyelitis optica spectrum disorders (NMO-SD). Typical brain lesions are now well described and have been integrated in the latest revision of NMO-SD criteria, but the NMO-SD MRI pattern remains not yet comprehensive. We report here extensive white matter lesions (EWML) mimicking leukodystrophy in a 50-year-old woman with long-lasting anti-AQP4+ NMO-SD. We suggest that EWML could be a possible brain MRI presentation of NMO-SD patients.

scholarly journals MRI brain lesions in asymptomatic boys with X-linked adrenoleukodystrophy

Neurology ◽  
2019 ◽  
Vol 92 (15) ◽  
pp. e1698-e1708 ◽  
Author(s):  
Afonso P. Liberato ◽  
Eric J. Mallack ◽  
Razina Aziz-Bose ◽  
Doug Hayden ◽  
Arne Lauer ◽  
...  
Keyword(s):  
Contrast Enhancement ◽  
Brain Mri ◽  
Brain Lesion ◽  
Brain Lesions ◽  
Linear Mixed Effect Model ◽  
Mri Findings ◽  
Mixed Effect ◽  
Asymptomatic Patients ◽  
Effect Model ◽  
Lesion Growth

ObjectiveTo describe the brain MRI findings in asymptomatic patients with childhood cerebral adrenoleukodystrophy (CCALD).MethodsWe retrospectively reviewed a series of biochemically or genetically confirmed cases of adrenoleukodystrophy followed at our institution between 2001 and 2015. We identified and analyzed 219 brain MRIs from 47 asymptomatic boys (median age 6.0 years). Patient age, MRI scan, and brain lesion characteristics (e.g., contrast enhancement, volume, and Loes score) were recorded. The rate of lesion growth was estimated using a linear mixed effect model.ResultsSixty percent of patients (28/47) showed brain lesions (median Loes score of 3.0 points; range 0.5–11). Seventy-nine percent of patients with CCALD (22/28) had contrast enhancement on first lesional or subsequent MRI. Lesion progression (Loes increase of ≥0.5 point) was seen in 50% of patients (14/28). The rate of lesion growth (mL/mo) was faster in younger patients (r = −0.745; p < 0.0001). Older patients (median age 14.4 y/o) tended to undergo spontaneous arrest of disease. Early lesions grew 46× faster when still limited to the splenium, genu of the corpus callosum, or the brainstem (p = 0.001).ConclusionWe provide a description of CCALD lesion development in a cohort of asymptomatic boys. Understanding the early stages of CCALD is crucial to optimize treatments for children diagnosed by newborn screening.

Cognitive and Behavioral Functioning in Childhood Acquired Demyelinating Syndromes

2016 ◽  
Vol 22 (10) ◽  
pp. 1050-1060 ◽  
Author(s):  
Christine Till ◽  
Austin Noguera ◽  
Leonard H. Verhey ◽  
Julia O’Mahony ◽  
E. Ann Yeh ◽  
...  
Keyword(s):  
Time Course ◽  
Binary Classification ◽  
Brain Mri ◽  
Poor Performance ◽  
Brain Lesions ◽  
Cognitive Outcome ◽  
Normative Values ◽  
Visuomotor Integration ◽  
Mri Scans

AbstractObjectives:The aim of this study was to describe cognitive, academic, and psychosocial outcomes after an incident demyelinating event (acquired demyelinating syndromes, ADS) in childhood and to investigate the contribution of brain lesions and confirmed MS diagnosis on outcome.Methods:Thirty-six patients with ADS (mean age=12.2 years,SD=2.7, range: 7–16 years) underwent brain MRI scans at presentation and at 6-months follow-up. T2-weighted lesions on MRI were assessed using a binary classification. At 6-months follow-up, patients underwent neuropsychological evaluation and were compared with 42 healthy controls.Results:Cognitive, academic, and behavioral outcomes did not differ between the patients with ADS and controls. Three of 36 patients (8.3%) were identified with cognitive impairment, as determined by performance falling ≤1.5SDbelow normative values on more than four independent tests in the battery. Poor performance on a visuomotor integration task was most common, observed among 6/32 patients, but this did not differ significantly from controls. Twelve of 36 patients received a diagnosis of MS within 3 years post-ADS. Patients with MS did not differ from children with monophasic ADS in terms of cognitive performance at the 6-months follow-up. Fatigue symptoms were reported in 50% of patients, irrespective of MS diagnosis. Presence of brain lesions at onset and 6 months post-incident demyelinating event did not associate with cognitive outcome.Conclusions:Children with ADS experience a favorable short-term neurocognitive outcome, even those confirmed to have MS. Longitudinal evaluations of children with monophasic ADS and MS are required to determine the possibility of late-emerging sequelae and their time course. (JINS, 2016,22, 1050–1060)

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