Atrophied Brain T2 Lesion Volume at MRI Is Associated with Disability                    Progression and Conversion to Secondary Progressive Multiple                    Sclerosis

A, Genovese; Hagemeier, Jesper; Bergsland, Niels; Jakimovski, Dejan; Dwyer, Michael G.; Ramasamy, Deepa P.; Lizarraga, Alexis A.; Hojnacki, David; Kolb, Channa; Weinstock‐Guttman, Bianca; Zivadinov, Robert

doi:10.1148/radiol.2019190306

Cited by 52 publications

(28 citation statements)

References 42 publications

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“…Since no pathological studies were conducted in this report, further studies are needed to verify the etiology of trigeminal atrophy. Both neurodegeneration and multiple sclerosis are closely related to age (21), which is consistent with the higher recurrence rate among the elderly patients than that among the younger patients in our study.…”

Section: Trigeminal Nerve Atrophysupporting

confidence: 90%

Long-Term Retrospective Analysis of Microvascular Decompression in Patients With Recurrent Trigeminal Neuralgia

Liu

Xiang

et al. 2020

Front. Neurol.

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Objective: To explore the clinical characteristics of patients with recurrent trigeminal neuralgia (TN) and the experience of microvascular decompression (MVD) in the treatment of such patients.Methods: We retrospectively analyzed clinical data, imaging examination results, surgical methods, and treatment efficacies in 127 patients with recurrent typical TN from January 2005 to December 2014.Results: The age of the recurrent group was higher than that of the non-recurrent group (p < 0.05). The duration of pain before the first MVD procedure was longer in the recurrent group than in the non-recurrent group (p < 0.05). Patients in the recurrent group were more likely to have compression of the trigeminal nerve by the vertebrobasilar artery (VBA) or multiple vessels than patients in the non-recurrent group (p < 0.05). A Kaplan–Meier curve showed a median pain-free survival of 12 months after the first MVD procedure. The severity of pain (preoperative visual analog scale [VAS] score) in patients with recurrence was lower than that in patients with first-onset TN (p < 0.05). Vessel compression, Teflon compression or granuloma and arachnoid adhesion were considered the main causes of recurrence. Postoperative Barrow Neurological Institute (BNI) scores in the redo MVD group were excellent (T = 2) for 69 patients (53.33%) and good (T = 3) for 46 patients (36.22%). The postoperative follow-up was 63–167 months (105.92 ± 25.66). During the follow-up, no recurrence was noted. All complications were cured or improved.Conclusions: Microvascular decompression (MVD) is an effective surgical method for the treatment of TN. For recurrent patients, reoperation can achieve good results.

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Section: Trigeminal Nerve Atrophysupporting

confidence: 90%

Long-Term Retrospective Analysis of Microvascular Decompression in Patients With Recurrent Trigeminal Neuralgia

Liu

Xiang

et al. 2020

Front. Neurol.

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“…Here, brain and upper cervical spinal cord atrophy rate and T 2 lesion volume were the most notable predictors of later progression ( Bermel and Bakshi, 2006 ; Goodin, 2006 ; Bar-Zohar et al , 2008 ; Fisniku et al , 2008 ; Popescu et al , 2013 ; De Stefano et al , 2014 ; Jacobsen et al , 2014 ; Kearney et al , 2014 ; Wattjes et al , 2015 ; Zivadinov et al , 2016 ; Healy et al , 2017 ; Casserly et al , 2018 ; Tsagkas et al , 2018 ; Andelova et al , 2019 ). Moreover, a recent study showed an association between ‘atrophied brain T2 lesion volume’ and later disability progression ( Genovese et al , 2019 ), making this quantitative measurement a promising tool for predicting future disease progression ( Zivadinov et al , 2018 ). Neurofilament concentration in blood has similarly been demonstrated as a biomarker for predicting multiple sclerosis progression ( Barro et al , 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Brain TSPO-PET predicts later disease progression independent of relapses in multiple sclerosis

Sucksdorff

Matilainen

Tuisku

et al. 2020

Brain

100

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Overactivation of microglia is associated with most neurodegenerative diseases. In this study we examined whether PET-measurable innate immune cell activation predicts multiple sclerosis disease progression. Activation of microglia/macrophages was measured using the 18-kDa translocator protein (TSPO)-binding radioligand 11C-PK11195 and PET imaging in 69 patients with multiple sclerosis and 18 age- and sex-matched healthy controls. Radioligand binding was evaluated as the distribution volume ratio from dynamic PET images. Conventional MRI and disability measurements using the Expanded Disability Status Scale were performed for patients at baseline and 4.1 ± 1.9 (mean ± standard deviation) years later. Fifty-one (74%) of the patients were free of relapses during the follow-up period. Patients had increased activation of innate immune cells in the normal-appearing white matter and in the thalamus compared to the healthy control group (P = 0.033 and P = 0.003, respectively, Wilcoxon). Forward-type stepwise logistic regression was used to assess the best variables predicting disease progression. Baseline innate immune cell activation in the normal-appearing white matter was a significant predictor of later progression when the entire multiple sclerosis cohort was assessed [odds ratio (OR) = 4.26; P = 0.048]. In the patient subgroup free of relapses there was an association between macrophage/microglia activation in the perilesional normal-appearing white matter and disease progression (OR = 4.57; P = 0.013). None of the conventional MRI parameters measured at baseline associated with later progression. Our results strongly suggest that innate immune cell activation contributes to the diffuse neural damage leading to multiple sclerosis disease progression independent of relapses.

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“…We observed a significant decline in T 2 -lesion volumes in patients over the 2 years (−0.54 ± 1.39 ml; p = 0.02), which could be due to remyelination activity in our sample. Another explanation for this finding would be the recently reported replacement of T 2 -lesions by cerebrospinal fluid spaces (Dwyer et al, 2018;Genovese et al, 2019).…”

Section: Study Limitationsmentioning

confidence: 96%

Decreasing brain iron in multiple sclerosis: The difference between concentration and content in iron MRI

Schweser

Hagemeier

Dwyer

et al. 2020

Human Brain Mapping

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Increased brain iron concentration is often reported concurrently with disease development in multiple sclerosis (MS) and other neurodegenerative diseases. However, it is unclear whether the higher iron concentration in patients stems from an influx of iron into the tissue or a relative reduction in tissue compartments without much iron. By taking into account structural volume, we investigated tissue iron content in the deep gray matter (DGM) over 2 years, and compared findings to previously reported changes in iron concentration. 120 MS patients and 40 age‐ and sex‐matched healthy controls were included. Clinical testing and MRI were performed both at baseline and after 2 years. Overall, iron content was calculated from structural MRI and quantitative susceptibility mapping in the thalamus, caudate, putamen, and globus pallidus. MS patients had significantly lower iron content than controls in the thalamus, with progressive MS patients demonstrating lower iron content than relapsing–remitting patients. Over 2 years, iron content decreased in the DGM of patients with MS, while it tended to increase or remain stable among controls. In the thalamus, decreasing iron content over 2 years was associated with disability progression. Our study showed that temporally increasing magnetic susceptibility in MS should not be considered as evidence for iron influx because it may be explained, at least partially, by disease‐related atrophy. Declining DGM iron content suggests that, contrary to the current understanding, iron is being removed from the DGM in patients with MS.

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Atrophied Brain T2 Lesion Volume at MRI Is Associated with Disability Progression and Conversion to Secondary Progressive Multiple Sclerosis

Cited by 52 publications

References 42 publications

Long-Term Retrospective Analysis of Microvascular Decompression in Patients With Recurrent Trigeminal Neuralgia

Long-Term Retrospective Analysis of Microvascular Decompression in Patients With Recurrent Trigeminal Neuralgia

Brain TSPO-PET predicts later disease progression independent of relapses in multiple sclerosis

Decreasing brain iron in multiple sclerosis: The difference between concentration and content in iron MRI

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