MRI and neurophysiological measures to predict course, disability and treatment response in multiple sclerosis

Leocani, Letizia; Rocca, Maria A.; Comı, Gıancarlo

doi:10.1097/wco.0000000000000333

Cited by 34 publications

(21 citation statements)

References 98 publications

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“…The retinal nerve fiber thickness and macular volume measures from OCT might also be useful in differentiating different subtypes of MS [98]. Other imaging-based measures, such as T 2 -lesion burden, have shown prognostic ability by prediction of future MS disability, e.g., [99], see also [100,101,102]. One potential avenue for future research is to evaluate the use of oxygen metabolism signals in MS prognosis.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Visual-Evoked Cerebral Metabolic Rate of Oxygen as a Diagnostic Marker in Multiple Sclerosis

et al. 2017

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A multiple sclerosis (MS) diagnosis often relies upon clinical presentation and qualitative analysis of standard, magnetic resonance brain images. However, the accuracy of MS diagnoses can be improved by utilizing advanced brain imaging methods. We assessed the accuracy of a new neuroimaging marker, visual-evoked cerebral metabolic rate of oxygen (veCMRO2), in classifying MS patients and closely age- and sex-matched healthy control (HC) participants. MS patients and HCs underwent calibrated functional magnetic resonance imaging (cfMRI) during a visual stimulation task, diffusion tensor imaging, T1- and T2-weighted imaging, neuropsychological testing, and completed self-report questionnaires. Using resampling techniques to avoid bias and increase the generalizability of the results, we assessed the accuracy of veCMRO2 in classifying MS patients and HCs. veCMRO2 classification accuracy was also examined in the context of other evoked visuofunctional measures, white matter microstructural integrity, lesion-based measures from T2-weighted imaging, atrophy measures from T1-weighted imaging, neuropsychological tests, and self-report assays of clinical symptomology. veCMRO2 was significant and within the top 16% of measures (43 total) in classifying MS status using both within-sample (82% accuracy) and out-of-sample (77% accuracy) observations. High accuracy of veCMRO2 in classifying MS demonstrated an encouraging first step toward establishing veCMRO2 as a neurodiagnostic marker of MS.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Visual-Evoked Cerebral Metabolic Rate of Oxygen as a Diagnostic Marker in Multiple Sclerosis

et al. 2017

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“…Further studies of all three are in progress. Electrophysiological techniques such as visual evoked potentials to measure conduction velocities represents a logical strategy to show remyelination as this would detect the reappearance of fast conduction velocities that are predicted to follow the restoration of salutatory conduction 188,216,217 . However, the sensitivity and specificity of this technique, in which the degree of variation can be considerable, remains to be determined.…”

Section: Box 2 | Schwann Cell Remyelination In the Cnsmentioning

confidence: 99%

Regenerating CNS myelin — from mechanisms to experimental medicines

2017

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Although the core concept of remyelination - based on the activation, migration, proliferation and differentiation of CNS progenitors - has not changed over the past 20 years, our understanding of the detailed mechanisms that underlie this process has developed considerably. We can now decorate the central events of remyelination with a host of pathways, molecules, mediators and cells, revealing a complex and precisely orchestrated process. These advances have led to recent drug-based and cell-based clinical trials for myelin diseases and have opened up hitherto unrecognized opportunities for drug-based approaches to therapeutically enhance remyelination.

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“…Numerous investigations of resting state-fcMRI (rs-fcMRI) have been conducted in PwMS, and have been reviewed previously ( Filippi et al, 2013 , Leocani et al, 2016 , Sacco et al, 2013 , Sbardella et al, 2015a ). Although findings are somewhat mixed, studies generally show PwMS exhibit reduced strength of connectivity in motor regions compared to individuals without MS ( Table 2 ).…”

Section: Brain Activity and Connectivity In Pwmsmentioning

confidence: 99%

How changes in brain activity and connectivity are associated with motor performance in people with MS

Peterson

Fling

2018

NeuroImage: Clinical

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People with multiple sclerosis (MS) exhibit pronounced changes in brain structure, activity, and connectivity. While considerable work has begun to elucidate how these neural changes contribute to behavior, the heterogeneity of symptoms and diagnoses makes interpretation of findings and application to clinical practice challenging. In particular, whether MS related changes in brain activity or brain connectivity protect against or contribute to worsening motor symptoms is unclear. With the recent emergence of neuromodulatory techniques that can alter neural activity in specific brain regions, it is critical to establish whether localized brain activation patterns are contributing to (i.e. maladaptive) or protecting against (i.e. adaptive) progression of motor symptoms. In this manuscript, we consolidate recent findings regarding changes in supraspinal structure and activity in people with MS and how these changes may contribute to motor performance. Furthermore, we discuss a hypothesis suggesting that increased neural activity during movement may be either adaptive or maladaptive depending on where in the brain this increase is observed. Specifically, we outline preliminary evidence suggesting sensorimotor cortex activity in the ipsilateral cortices may be maladaptive in people with MS. We also discuss future work that could supply data to support or refute this hypothesis, thus improving our understanding of this important topic.

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MRI and neurophysiological measures to predict course, disability and treatment response in multiple sclerosis

Cited by 34 publications

References 98 publications

Evaluation of Visual-Evoked Cerebral Metabolic Rate of Oxygen as a Diagnostic Marker in Multiple Sclerosis

Evaluation of Visual-Evoked Cerebral Metabolic Rate of Oxygen as a Diagnostic Marker in Multiple Sclerosis

Regenerating CNS myelin — from mechanisms to experimental medicines

How changes in brain activity and connectivity are associated with motor performance in people with MS

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