HAM/TSP: association between white matter lesions on magnetic resonance imaging, clinical and cerebrospinal fluid findings

OBJECTIVE: To investigate the association between clinical data, white matter lesions and inflammatory cerebrospinal fluid (CSF) findings in HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). METHOD: We studied brain and cervical spinal cord on magnetic resonance imaging (MRI) and CSF examinations of 28 Brazilian HAM/TSP patients. RESULTS: The majority of patients had severe neurological incapacity with EDSS median of 6.5 (3-8). The brain MRI showed white matter lesions (75%) and atrophy (14%). The preferential brain location was periventricular. Cervical demyelination lesions occurred in 11% of the cases, and cervical atrophy in 3.5%. One patient had enhancement lesions on T1 cervical spinal cord MRI. Cases with spinal cord lesions had signs of acute CSF inflammation. The brain white matter lesions predominated in the patients with higher age. CONCLUSION: Our data suggest that an active inflammatory process is associated with the cervical spinal cord lesions in HAM/TSP. The brain abnormalities are not related to the clinical picture of HAM/TSP.

Download Full-text

Volumetric MRI Assessment of Brain and Spinal Cord in Finnish Twins Discordant for Multiple Sclerosis

Medicina ◽

10.3390/medicina48090065 ◽

2012 ◽

Vol 48 (9) ◽

pp. 65

Author(s):

Hanna Kuusisto ◽

Xingchen Wu ◽

Prasun Dastidar ◽

Tiina Luukkaala ◽

Irina Elovaara

Keyword(s):

Magnetic Resonance Imaging ◽

Multiple Sclerosis ◽

Spinal Cord ◽

White Matter ◽

Magnetic Resonance ◽

Brain Size ◽

White Matter Lesions ◽

Resonance Imaging ◽

Brain And Spinal Cord ◽

The Brain

Background and Objective. Brain size, white matter hyperintensity, and the development of brain atrophy are known to be highly heritable. The decrease of brain volume starts from the very onset of multiple sclerosis and is 10-fold compared with normal aging. The aim of this study was to assess whether the brain and spinal cord volumes and the volume of white matter lesions differed between twins with multiple sclerosis and their asymptomatic co-twins. Material and Methods. A co-twin control method was used to evaluate whether the brain and spinal cord volumes differ between twins with multiple sclerosis and their co-twins. Nineteen twin pairs were studied neurologically, and the volumes of T1, T2, FLAIR, and gadolinium-enhanced lesions and those of the brain and the spinal cord were obtained by magnetic resonance imaging. Results. Significant differences in the brain (P=0.064) or spinal cord (P=0.648) volumes were not detected. Four of the 7 monozygotic and 5 of the 12 dizygotic co-twins had focal brain white matter lesions, but none fulfilled the magnetic resonance imaging criteria of Barkhof. Spinal cord lesions were not seen in any of the co-twins. Conclusions. The absence of a significant difference in the brain or spinal cord volume between the twins with multiple sclerosis and their co-twins supports the recent observation of brain size and the development of brain atrophy being highly heritable.

Download Full-text

Predicting Injury Severity and Neurological Recovery after Acute Cervical Spinal Cord Injury: A Comparison of Cerebrospinal Fluid and Magnetic Resonance Imaging Biomarkers

Journal of Neurotrauma ◽

10.1089/neu.2017.5357 ◽

2018 ◽

Vol 35 (3) ◽

pp. 435-445 ◽

Cited By ~ 31

Author(s):

Turker Dalkilic ◽

Nader Fallah ◽

Vanessa K. Noonan ◽

Sanam Salimi Elizei ◽

Kevin Dong ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Cerebrospinal Fluid ◽

Magnetic Resonance ◽

Injury Severity ◽

Cervical Spinal Cord ◽

Imaging Biomarkers ◽

Resonance Imaging ◽

Cord Injury

Download Full-text

Breakthrough Disease While on Multiple Sclerosis Immunomodulatory Therapy

10.1093/med/9780197583425.003.0017 ◽

2021 ◽

pp. 55-56

Author(s):

Jonathan L. Carter

Keyword(s):

Magnetic Resonance Imaging ◽

Multiple Sclerosis ◽

Spinal Cord ◽

White Matter ◽

Magnetic Resonance ◽

Disease Activity ◽

Brain Magnetic Resonance Imaging ◽

White Matter Lesions ◽

Dimethyl Fumarate ◽

Resonance Imaging

A 36-year-old woman with a history of relapsing-remitting multiple sclerosis was evaluated for new multiple sclerosis symptoms accompanied by new, enhancing, white matter lesions on brain magnetic resonance imaging. Her multiple sclerosis presented with L’hermitte sign when she was 24 years old. She had onset of bilateral lower extremity and left upper extremity tingling at age 26 years. Magnetic resonance imaging and cerebrospinal fluid examination at the time were supportive of the diagnosis of multiple sclerosis, and disease-modifying therapy was recommended by her neurologist. She initiated therapy with dimethyl fumarate at age 30 years after several further relapses. Surveillance magnetic resonance imaging showed new gadolinium-enhancing lesions on brain magnetic resonance imaging on each of 3 consecutive yearly scans. Urine culture and sensitivity tests were performed to rule out occult urinary tract infection; results of this testing were negative. magnetic resonance imaging of the brain concurrently showed new enhancing white matter lesions. The patient was diagnosed with clinical and radiographic breakthrough disease activity while receiving therapy for multiple sclerosis. The patient was treated with 5 days of intravenous methylprednisolone for her relapse. After discussion with the patient, it was decided to transition therapy from dimethyl fumarate to ocrelizumab infusions for her breakthrough disease activity. This decision was further supported by the patient’s concerns that she might be entering an early progressive phase of the disease. In patients with spinal-predominant multiple sclerosis, or with symptoms potentially indicating new spinal cord involvement, it may be necessary to include spinal cord imaging to assess for new disease activity.

Download Full-text

Brain Magnetic Resonance Imaging White-Matter Lesions and Cerebrospinal Fluid Findings in Patients with Acute Intermittent Porphyria

European Neurology ◽

10.1159/000074909 ◽

2004 ◽

Vol 51 (1) ◽

pp. 1-5 ◽

Cited By ~ 21

Author(s):

Ingemar Bylesjö ◽

Ole-Lars Brekke ◽

Jan Prytz ◽

Trine Skjeflo ◽

Rolf Salvesen

Keyword(s):

Magnetic Resonance Imaging ◽

Cerebrospinal Fluid ◽

White Matter ◽

Magnetic Resonance ◽

Brain Magnetic Resonance Imaging ◽

White Matter Lesions ◽

Acute Intermittent Porphyria ◽

Resonance Imaging

Download Full-text

Magnetic resonance imaging of the cervical spinal cord in multiple sclerosis at 7T

Multiple Sclerosis Journal ◽

10.1177/1352458515591070 ◽

2015 ◽

Vol 22 (3) ◽

pp. 320-328 ◽

Cited By ~ 31

Author(s):

Adrienne N Dula ◽

Siddharama Pawate ◽

Richard D Dortch ◽

Robert L Barry ◽

Kristen M George-Durrett ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Multiple Sclerosis ◽

Spinal Cord ◽

White Matter ◽

Magnetic Resonance ◽

High Resolution ◽

Healthy Volunteers ◽

Cervical Spinal Cord ◽

Resonance Imaging ◽

Lower Field

Background: The clinical course of multiple sclerosis (MS) is mainly attributable to cervical and upper thoracic spinal cord dysfunction. High-resolution, 7T anatomical imaging of the cervical spinal cord is presented. Image contrast between gray/white matter and lesions surpasses conventional, clinical T1- and T2-weighted sequences at lower field strengths. Objective: To study the spinal cord of healthy controls and patients with MS using magnetic resonance imaging at 7T. Methods: Axial (C2–C5) T1- and T2*-weighted and sagittal T2*-/spin-density-weighted images were acquired at 7T in 13 healthy volunteers (age 22–40 years), and 15 clinically diagnosed MS patients (age 19–53 years, Extended Disability Status Scale, (EDSS) 0–3) in addition to clinical 3T scans. In healthy volunteers, a high-resolution multi-echo gradient echo scan was obtained over the same geometry at 3T. Evaluation included signal and contrast to noise ratios and lesion counts for healthy and patient volunteers, respectively. Results/conclusion: High-resolution images at 7T exceeded resolutions reported at lower field strengths. Gray and white matter were sharply demarcated and MS lesions were more readily visualized at 7T compared to clinical acquisitions, with lesions apparent at both fields. Nerve roots were clearly visualized. White matter lesion counts averaged 4.7 vs 3.1 (52% increase) per patient at 7T vs 3T, respectively ( p=0.05).

Download Full-text

White matter lesions in magnetic resonance imaging of the brain in 56 patients with visual vertigo

The Journal of Laryngology & Otology ◽

10.1017/s0022215118000701 ◽

2018 ◽

Vol 132 (06) ◽

pp. 550-553 ◽

Cited By ~ 1

Author(s):

P A Dimitriadis ◽

M Saad ◽

M S Igra ◽

R Mandavia ◽

C Bowes ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

White Matter ◽

Magnetic Resonance ◽

Patient Group ◽

White Matter Lesions ◽

Control Group ◽

Resonance Imaging ◽

And Gender ◽

Visual Vertigo ◽

The Brain

AbstractBackgroundVisual vertigo is defined as a condition in which there is worsening or triggering of vestibular symptoms in certain visual environments. Previous studies have associated visual vertigo with an increased prevalence of underlying white matter lesions on brain imaging.MethodThis study evaluated the magnetic resonance imaging scans of the brain from a cohort of patients with visual vertigo, and compared the outcomes to an age- and gender-matched group of healthy volunteers.Results and conclusionWhite matter lesions were observed in 17.9 per cent of the patient group and in 16.3 per cent of the control group. The prevalence of white matter lesions in the patient group was not too different to that expected based on age.

Download Full-text