Relevance of Brain Lesion Distribution and Frequency for Short-Term Conversion of Patients with Clinically Isolated Syndrome to Multiple Sclerosis (P03.033)

Background/Objectives: The objective of this study was to investigate associations between the spatial distribution of brain lesions and clinical outcomes in a cohort of people followed up 20 years after presentation with a clinically isolated syndrome (CIS) suggestive of multiple sclerosis (MS). Methods: Brain lesion probability maps (LPMs) of T1 and T2 lesions were generated from 74 people who underwent magnetic resonance imaging (MRI) and clinical assessment a mean of 19.9 years following a CIS. One-tailed t-test statistics were used to compare LPMs between the following groups: clinically definite (CD) MS and those who remained with CIS, with an abnormal MRI; people with MS and an Expanded Disability Status Scale (EDSS) ≤3 and >3; people with relapsing–remitting (RR) and secondary progressive (SP) MS. The probability of each voxel being lesional was analysed adjusting for age and gender using a multiple linear regression model. Results: People with CDMS were significantly more likely than those with CIS and abnormal scan 20 years after onset to have T1 and T2 lesions in the corona radiata, optic radiation, and splenium of the corpus callosum (periventricularly) and T2 lesions in the right fronto-occipital fasciculus. People with MS EDSS >3, compared with those with EDSS ≤3, were more likely to have optic radiation and left internal capsule T2 lesions. No significant difference in lesion distribution was noted between RRMS and SPMS. Conclusion: This work demonstrates that lesion location characteristics are associated with CDMS and disability after long-term follow-up following a CIS. The lack of lesion spatial distribution differences between RRMS and SPMS suggests focal pathology affects similar regions in both subgroups.

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Deep learning of brain lesion patterns and user-defined clinical and MRI features for predicting conversion to multiple sclerosis from clinically isolated syndrome

Computer Methods in Biomechanics and Biomedical Engineering Imaging & Visualization ◽

10.1080/21681163.2017.1356750 ◽

2017 ◽

Vol 7 (3) ◽

pp. 250-259 ◽

Cited By ~ 3

Author(s):

Youngjin Yoo ◽

Lisa Y. W. Tang ◽

David K. B. Li ◽

Luanne Metz ◽

Shannon Kolind ◽

...

Keyword(s):

Multiple Sclerosis ◽

Deep Learning ◽

Brain Lesion ◽

Clinically Isolated Syndrome ◽

Mri Features

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Brain Lesion Load and Anatomic Distribution in Patients With Juvenile Clinically Isolated Syndrome Predicts Rapidly Advanced to Multiple Sclerosis

Journal of Child Neurology ◽

10.1177/0883073818774716 ◽

2018 ◽

Vol 33 (10) ◽

pp. 633-638

Author(s):

Shay Menascu ◽

Carolina Legarda ◽

Shmuel Miron ◽

Anat Achiron

Keyword(s):

Multiple Sclerosis ◽

Brain Mri ◽

Age At Onset ◽

Brain Lesion ◽

Disease Onset ◽

Clinically Isolated Syndrome ◽

Lesion Load ◽

Magnetic Resonance Imaging Mri ◽

One Year ◽

Multiple Sclerosis Patients

The aim was to assess brain lesion load and anatomical distribution in patients with juvenile clinically isolated syndrome and define magnetic resonance imaging (MRI) variables associated with rapidly advancing to multiple sclerosis. Patients were followed for one year after disease onset. Patients who experienced a second relapse were defined as those who rapidly advanced to multiple sclerosis. In all, 46 juvenile patients with a clinical presentation suggestive of multiple sclerosis were evaluated; 21 with gadolinium-enhancing lesions on initial brain MRI were excluded as they had already fulfilled the diagnosis criteria for multiple sclerosis. A total of 25 patients, 10 males and 15 females (mean ± SE age at onset 15.6 ± 0.6 years), met the definition of clinically isolated syndrome. The presence of a corpus callosum lesion at onset significantly differentiated between sustained clinically isolated syndrome and patients who rapidly advanced to multiple sclerosis.

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Longitudinal evaluation of depression and anxiety in patients with clinically isolated syndrome at high risk of developing early multiple sclerosis

Multiple Sclerosis Journal ◽

10.1191/1352458503ms921oa ◽

2003 ◽

Vol 9 (3) ◽

pp. 302-306 ◽

Cited By ~ 39

Author(s):

S Di Legge ◽

M C Piattella ◽

C Pozzilli ◽

P Pantano ◽

F Caramia ◽

...

Keyword(s):

Multiple Sclerosis ◽

Depressive Symptoms ◽

Brain Lesion ◽

Clinically Isolated Syndrome ◽

Temporal Region ◽

Clinical Relapse ◽

Depression And Anxiety ◽

Lesion Load ◽

Mri Scans ◽

The Right

We investigated the relationship between emotional changes, brain lesion burden and development of multiple sclerosis (MS). Thirty-seven consecutive patients with clinically isolated syndrome (C IS) were prospectively assessed with the Expanded Disability Status Scale (EDSS), the 21-item Beck Depression Inventory (BDI), the State-Trait A nxiety Inventory (STAI) and gadolinium enhanced (Gd+) MRI scans. BDI and STAI were also administered to 36 age-matched controls. C onversion to MS was defined as the occurrence of a clinical relapse. C IS patients were more likely to endorse symptoms of anxiety and depression than controls. Baseline scores for depression and anxiety did not correlate with the total lesion load (i.e., volume of Gd+, T2 and T1 lesions) and the number of Gd+ lesions during the first six months of follow-up. A positive correlation was found between severity of depressive scores and the lesion load in the right temporal region (P =0.005). After 339-6 months of the study entry, patients who had a clinical relapse were more frequently depressed (P =0.001) than those relapse free. Emotional disturbances are frequently observed in C IS patients and show a tendency towards a normalization in relapse-free patients. The increased rate of depressive symptoms observed in patients who developed MS seems to result from a combination of psychological and organic features. The lesion load in the right temporal region is confirmed as a key area for developing depressive symptoms, even in the early phase of the disease.

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