MRI T2 lesion burden in multiple sclerosis

Li, D K B; Held, Ulrike; Petkau, John; Däumer, Martin; Barkhof, Frederik; Fazekas, Franz; Frank, J. A.; Kappos, Ludwig; Miller, Donald H.; Simon, Jack H.; Wolinsky, Jerry S.; Filippi, Massimo

doi:10.1212/01.wnl.0000210506.00078.5c

Cited by 187 publications

(130 citation statements)

References 25 publications

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“…We found conversion to CDMS to occur more frequently in younger patients, which is in line with the CHAMPS study [5]. Accordingly, relapse frequency has previously been recognised to be higher in younger patients [8,13]. Also, the observation that patients who had positive CSF findings convert more frequently has been reported previously [18,19].…”

Section: Discussionsupporting

confidence: 91%

Subgroups of the BENEFIT study: Risk of developing MS and treatment effect of interferon beta-1b

et al. 2007

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Section: Discussionsupporting

confidence: 91%

Subgroups of the BENEFIT study: Risk of developing MS and treatment effect of interferon beta-1b

et al. 2007

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“…Conventional magnetic resonance imaging (MRI) of the brain shows typical white matter (WM) lesions on proton density (PD)-weighted and T2-weighted images. Predicting prognosis and making treatment decisions for individual patients based on these images is challenging, as correlations between brain lesion burden visualized on MRI, and disability progression measured by expanded disability status scale (EDSS, possible range: 0 -10, with a higher score indicating a higher degree of disability (1)), are only moderate (2)(3)(4)(5)(6)(7)(8)(9). This may be caused by several mechanisms: the presence of symptomatic spinal cord lesions in combination with relatively few brain lesions, pathology in normal-appearing WM (NAWM) and normal-appearing gray matter that is not visualized on conventional MRI, pathological heterogeneity (edema, demyelination, axonal loss, or gliosis) of lesions visualized on PD-weighted and T2-weighted images, and the fact that a proportion of the lesions visualized on MRI may be clinically silent (2)(3)(4)(5)(6)(7)(8)(9).…”

Section: Multiple Sclerosis (Ms) Is a Multifocal Inflammatory Demyelimentioning

confidence: 99%

Clinical correlations of brain lesion distribution in multiple sclerosis

Vellinga¹,

Geurts²,

Rostrup

et al. 2009

Magnetic Resonance Imaging

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Purpose: To explore relations between spatial distribution of multiple sclerosis (MS) lesions, and disability. In MS, the presence of asymptomatic brain lesions challenges the prediction of disability based on conventional brain MRI. Hypothesizing that symptomatology may partly be determined by lesion location, this retrospective study explored relations between lesion location and disability using voxelwise analyses in standard space. Materials and Methods:Using nonparametric permutation-based statistics, voxelwise lesion probability on T2 lesion masks was related to expanded disability status scale (EDSS) and MS functional composite (MSFC) subdomain scores and demographic characteristics of 325 MS patients. To identify statistically significant locations, a cluster-forming threshold of 3.1 was used. Results:In clusters in the periventricular region, lesion probability correlated significantly (P Ͻ 0.001) with disability and disease duration, and was higher in progressive than in relapsing disease. When controlled for lesion load (LL), no significant clusters survived. Presence and number of spinal cord lesions did not correlate with lesion probability in any location, and did not influence correlations with disability when included in its analyses.Conclusion: Periventricular lesions were related to disability. LL influenced relations between disability and lesion probability throughout the brain, suggesting interplay between lesional burden and its location in determining disability in MS.

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“…1 All of the diseasemodifying agents approved by the Food and Drug Administration (FDA) have shown a significant benefit in limiting the progression of T2LV. However, one of the major limitations in using T2LV as a longitudinal surrogate measure is the plateauing relationship between T2LV and disability, 20 which reflects in part the engulfing of T2 lesions by the expanding CSF spaces in the midst of progressive brain atrophy and disease progression; this plateauing also probably reflects the role of diffuse occult disease in WM and GM that escapes detection with conventional MRI.…”

Section: Figmentioning

confidence: 99%

MRI in Multiple Sclerosis: What’s Inside the Toolbox?

et al. 2007

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Summary: Magnetic resonance imaging (MRI) has played a central role in the diagnosis and management of multiple sclerosis (MS). In addition, MRI metrics have become key supportive outcome measures to explore drug efficacy in clinical trials. Conventional MRI measures have contributed to the understanding of MS pathophysiology at the macroscopic level yet have failed to provide a complete picture of underlying MS pathology. They also show relatively weak relationships to clinical status such as predictive strength for clinical progression. Advanced quantitative MRI measures such as magnetization transfer, spectroscopy, diffusion imaging, and relaxometry techniques are somewhat more specific and sensitive for underlying pathology. These measures are particularly useful in revealing diffuse damage in cerebral white and gray matter and therefore may help resolve the dissociation between clinical and conventional MRI findings. In this article, we provide an overview of the array of tools available with brain and spinal cord MRI technology as it is applied to MS. We review the most recent data regarding the role of conventional and advanced MRI techniques in the assessment of MS. We focus on the most relevant pathologic and clinical correlation studies relevant to these measures.

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MRI T2 lesion burden in multiple sclerosis

Abstract: This study confirmed the limited correlation between clinical manifestations and T2 burden of disease (BOD) but revealed an important plateauing relationship between T2 BOD and disability.

Cited by 187 publications

References 25 publications

Subgroups of the BENEFIT study: Risk of developing MS and treatment effect of interferon beta-1b

Subgroups of the BENEFIT study: Risk of developing MS and treatment effect of interferon beta-1b

Clinical correlations of brain lesion distribution in multiple sclerosis

MRI in Multiple Sclerosis: What’s Inside the Toolbox?

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