When confronted by a patient with the radiologically isolated syndrome

Chataway, Jeremy

doi:10.1136/jnnp.2010.224931

Cited by 9 publications

(10 citation statements)

References 17 publications

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“…Chattaway, 2008 and2010;Gilmore et al, 2010;Lebrun et al, 2008;Miller et al, 2008). In any case, we must keep in mind that direct scientific evidence is still lacking.…”

Section: Myo-inositol (Mins) At 35 Ppmmentioning

confidence: 99%

“…However, by occasion some patients, who receive a MRI of their brain (because of a wide range of 'unspecific' symptoms, and because MRI is now widely available), show asymptomatic lesions suggestive for MS (Chataway, 2010). Recently, these 'patients' were classified as radiological isolated syndrome (RIS) or clinical isolated syndrome (CIS) type 5 .…”

Section: The Clinical-radiological Paradox Of Msmentioning

confidence: 99%

“…Recently, these 'patients' were classified as radiological isolated syndrome (RIS) or clinical isolated syndrome (CIS) type 5 . It is controversially discussed, whether these 'patients' should be followed closely, or even treated (Chataway, 2008(Chataway, , 2010Gilmore et al, 2010;Lebrun et al, 2008;Miller et al, 2008;Sellner et al, 2010;Siva et al, 2009). …”

Section: The Clinical-radiological Paradox Of Msmentioning

confidence: 99%

See 2 more Smart Citations

MR Spectroscopy in Multiple Sclerosis - A New Piece of the Puzzle or Just a New Puzzle

Aboul‐Enein¹

2012

Magnetic Resonance Spectroscopy

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“…Chattaway, 2008 and2010;Gilmore et al, 2010;Lebrun et al, 2008;Miller et al, 2008). In any case, we must keep in mind that direct scientific evidence is still lacking.…”

Section: Myo-inositol (Mins) At 35 Ppmmentioning

confidence: 99%

Section: The Clinical-radiological Paradox Of Msmentioning

confidence: 99%

Section: The Clinical-radiological Paradox Of Msmentioning

confidence: 99%

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MR Spectroscopy in Multiple Sclerosis - A New Piece of the Puzzle or Just a New Puzzle

Aboul‐Enein¹

2012

Magnetic Resonance Spectroscopy

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“…Our data suggest that all MRI criteria in RIS cases should be used parsimoniously as long as MS remains an exclusionary diagnosis. Unless patients develop a clinical symptom typical of a demyelinating episode, MRI analysis alone is not enough to confirm the diagnosis of MS 1, 2,22 . In our series of patients, there was no difference in median ages between both groups (36.75 and 39.75 years old with and without clinical symptoms, respectively).…”

Section: Discussionmentioning

confidence: 99%

Incidental demyelinating inflammatory lesions in asymptomatic patients: a Brazilian cohort with radiologically isolated syndrome and a critical review of current literature

Maia

Rocha

Barros

et al. 2012

Arq. Neuro-Psiquiatr.

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Despite the definition of specific diagnostic criteria to identify radiologically isolated syndrome (RIS) suggestive of multiple sclerosis, its natural history remains incompletely understood. We retrospectively analyzed a Brazilian cohort of 12 patients to clarify their features and to emphasize the role of imaging predictors in clinical conversion. We demonstrated that, although some individuals did not exhibit progression over a lengthy follow-up period (16.7%), most patients will progress clinically or radiologically in the initial years of the follow-up (83.3%). Infratentorial and spinal cord involvement, as well as the total number of lesions, were more relevant predictors of progression than gadolinium enhancement. Further studies remain necessary to define the risk of conversion in males and to clarify the cognitive abilities of RIS patients. This study may provide an improved understanding of the natural course and evolution of incidental magnetic resonance imaging lesions, and further assists with the management of RIS in clinical practice.Key words: multiple sclerosis, radiologically isolated syndrome, incidental demyelination, magnetic resonance. reSUMO Apesar da definição dos critérios diagnósticos específicos para identificar a síndrome radiológica isolada (SRI) sugestiva de esclerose múl-tipla, sua história natural ainda não foi completamente entendida. Analisamos retrospectivamente uma coorte brasileira de 12 pacientes visando a esclarecer suas características e enfatizar o papel da imagem em predizer conversão clínica. Embora alguns indivíduos não apresentem progressão em longo período de acompanhamento (16,7%), a maioria dos pacientes com SRI progrediu clínica ou radiologicamente nos primeiros anos do seguimento (83,3%). O comprometimento infratentorial e da medula espinhal, bem como o número total de lesões, foram mais relevantes em predizer a progressão que a presença de impregnação pelo gadolínio. Estudos futuros são necessários para definir o risco de conversão em homens e para esclarecer a repercussão cognitiva da SRI. Este estudo pode ampliar o entendimento da história natural e da evolução das lesões incidentais à imagem de ressonância magnética contribuindo para a adequada condução clínica da SRI.Palavras-Chave: esclerose múltipla, síndrome radiológica isolada, desmielinização incidental, ressonância magnética.

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“…Thalamic tissue volume loss has been found in all MS subtypes. 58 Thalamic nuclei are GM structures that play a major role in cortical activation, relaying sensory information to the higher cortical centers that influence cognition, sensory and motor functions. Involvement of these structures is associated with a wide range of clinical manifestations, including cognitive impairments and motor deficits in patients with MS. 59 It might become an important biomarker of disease progression.…”

Section: Gray Matter Atrophy In Multiple Sclerosismentioning

confidence: 99%

The role of MR volumetry in brain atrophy assessment in multiple sclerosis: A review of the literature

Marciniewicz¹,

Podgórski²,

Sąsiadek³

et al. 2019

Adv Clin Exp Med

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We review the current role of magnetic resonance (MR) volumetry as a meaningful indicator of neurodegeneration and clinical disease progression in multiple sclerosis (MS) patients. Based on a review of the current literature we summarize the mechanisms that contribute to brain atrophy. We present the newest magnetic resonance imaging (MRI)-based methods used in atrophy quantification. We also analyze important biological factors which can influence the accuracy of brain atrophy evaluation. Evidence shows that measures of brain volume (BV) have the potential to be an important determinant of disease progression to a greater extent than conventional lesion assessment. Finally, scientific reports concerning limitations of MRI-based volumetry that affect its implementation into routine clinical practice are also reviewed. The technical challenges that need to be overcome include creating a standardized protocol for image acquisition − a fully automated, accurate and reproducible method that allows comparison in either single-center or multicenter settings. In the near future, quantitative MR research will probably be the basic method used in neurology to monitor the rate of atrophic processes and clinical deterioration in MS patients, and to evaluate the results of treatment.

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When confronted by a patient with the radiologically isolated syndrome

Cited by 9 publications

References 17 publications

MR Spectroscopy in Multiple Sclerosis - A New Piece of the Puzzle or Just a New Puzzle

MR Spectroscopy in Multiple Sclerosis - A New Piece of the Puzzle or Just a New Puzzle

Incidental demyelinating inflammatory lesions in asymptomatic patients: a Brazilian cohort with radiologically isolated syndrome and a critical review of current literature

The role of MR volumetry in brain atrophy assessment in multiple sclerosis: A review of the literature

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