White matter involvement beyond the optic nerves in CRION as assessed by diffusion tensor imaging

Çolpak, Ayşe İlksen; Kurne, Aslı; Oğuz, Kader Karlı; Has, Arzu Ceylan; Dolgun, Anıl; Kansu, Tülay

doi:10.3109/00207454.2014.896912

Cited by 10 publications

(12 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, other white matter areas exhibited changes suggestive of inflammation or demyelination. Therefore, these authors concluded that, in the brains of these patients, a combination of pathological processes seemed to be produced, supporting the hypothesis that CRION is a disorder independent from MS or NMOSD (23).…”

Section: Discussionsupporting

confidence: 55%

“…The only work that studied the impact of CRION on the brain was published by Colpak et al (23), who studied changes in the apparently normal white matter in a group of six CRION patients using DTI. These authors demonstrated widespread effects in the brain that implicated not only the visual tract, as was expected due to the Wallerian degeneration, but also the cerebellum, right superior cerebellar peduncle, body and splenium of the corpus callosum, left thalamus, posterior cingulum, and bilateral posterior bundles of the inferior fronto-occipital tracts, and the inferior longitudinal fasciculi, which exhibited increased fraction of anisotropy (FA) and decreased radial diffusivity (RD).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Brain Atrophy in Relapsing Optic Neuritis Is Associated With Crion Phenotype

et al. 2019

Front. Neurol.

View full text Add to dashboard Cite

Background and objective: Chronic relapsing inflammatory optic neuritis (CRION) is one of the more common phenotypes related to myelin oligodendrocyte glycoprotein antibodies (MOG-Abs). The absence of specific biomarkers makes distinguishing between CRION and relapsing inflammatory ON (RION) difficult. A recent work has suggested a widespread affectation of the central nervous system in CRION patients. In order to search for a potential CRION marker we have measured brain atrophy in a cohort of patients, stratified by phenotypes: CRION, RION, multiple sclerosis with a history of optic neuritis (MS-ON), and MOG-Abs status.Methods: A cross-sectional study was conducted in 31 patients (seven CRION, 11 RION, and 13 MS-ON). All patients were tested for MOG and aquaporin-4 antibodies (AQ4-Abs). Clinical data were collected. Brain atrophy was calculated by measuring the brain parenchyma fraction (BPF) with Neuroquant® software.Results: Four of seven CRION patients and one of 11 RION patients were positive for MOG-Abs (p = 0.046) and no MS-ON patients tested positive to MOG-Abs. All patients were negative to AQ4-Abs. The BPF was lower in patients with CRION than patients with RION (70.6 vs. 75.3%, p = 0.019) and similar to that in MS-ON patients.Conclusions: Brain atrophy in idiopathic inflammatory relapsing ON is present in patients with the CRION phenotype. Data from this study reflect that the optic nerve is a main target involved in these patients but not the only one. Our results should be further investigated in comprehensive and prospective studies.

show abstract

Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Brain Atrophy in Relapsing Optic Neuritis Is Associated With Crion Phenotype

et al. 2019

Front. Neurol.

View full text Add to dashboard Cite

show abstract

“…Similar findings have been previously shown in the NAWM of patients with chronic recurrent inflammatory optic neuropathy, in T1-hyperintense lesions and normal appearing tissue in patients with MS. The authors attributed these findings to remyelination and glial activation (29,30). Low expanded disability status scale and absence of conversion to MS during the two years of the study may have been partly related to remyelination in the NAWM, occurring as a compensatory mechanism.…”

Section: Discussionmentioning

confidence: 95%

Influence of cigarette smoking on white matter in patients with clinically isolated syndrome as detected by diffusion tensor imaging

Durhan¹,

Diker²,

Has³

et al. 2016

Diagn Interv Radiol

Self Cite

View full text Add to dashboard Cite

C linically isolated syndrome (CIS), an inflammatory demyelinating disorder of the central nervous system, is the first clinical episode with features predictive of multiple sclerosis (MS) (1). Many environmental risk factors for conversion from CIS to MS were shown in recent studies (1,2). Among these, cigarette smoking was shown to increase the risk of developing MS even in passive smokers (3), worsen clinical disability, and exacerbate disease progression (4) .Diffusion tensor imaging (DTI) gives the opportunity to evaluate the tissue integrity, mainly the white matter (WM). Through changes in metrics such as fractional anisotropy (FA) and mean diffusivity (MD), DTI enables the assessment of axonal organization and myelin attenuation in addition to the WM lesions evaluated by conventional magnetic resonance imaging (MRI) sequences (5). The brains of MS patients have demonstrated that an increase in MD and a decrease in FA values were far beyond fluid attenuation inversion recovery (FLAIR) hyperintense lesions, commonly used as a clinical parameter of MS (6, 7). Brain parenchyma with no apparent lesion, namely, the normal-appearing white matter (NAWM), has drawn much attention due to the presence of not only histopathologic and radiologic abnormalities but also a close association with clinical disability and disease progression (8). Changes in the NAWM may also be responsible for the clinicoradiologic discrepancy observed in many patients (6). In addition, several MRI studies have shown significantly altered FA measures in specific brain regions in healthy smoker individuals (9, 10). Although a number of studies have investigated the impact of smoking on patients with MS (4,11), to the best of our knowledge, no study has studied the influence of smoking on the WM in patients with CIS using DTI.In this study we sought to determine the effects of smoking on NAWM, lesions, and perilesional WM of patients with CIS. The secondary objective was to examine whether diffu- PURPOSECigarette smoking has been associated with increased occurrence of multiple sclerosis (MS), as well as clinical disability and disease progression in MS. We aimed to assess the effects of smoking on the white matter (WM) in patients with clinically isolated syndrome (CIS) using diffusion tensor imaging. METHODSSmoker patients with CIS (n=16), smoker healthy controls (n=13), nonsmoker patients with CIS (n=17) and nonsmoker healthy controls (n=14) were included. Thirteen regions-of-interest including nonenhancing T1 hypointense lesion and perilesional WM, and 11 normal-appearing white matter (NAWM) regions were drawn on color-coded fractional anisotropy (FA) maps. Lesion load was determined in terms of number and volume of WM hyperintensities. RESULTSA tendency towards greater lesion load was found in smoker patients. T1 hypointense lesions and perilesional WM had reduced FA and increased mean diffusivity to a similar degree in smoker and nonsmoker CIS patients. Compared with healthy smokers, smoker CIS patients had more extensive NAWM changes...

show abstract

“…The strong response to immuno-suppressive treatment suggests that the etiology of CRION is at least partially immune-mediated. Colpak et al [7] reported that brain white matter (WM) that appeared normal on a brain MRI demonstrated widespread abnormalities in a cohort of CRION patients when assessed via diffusion tensor imaging (DTI). DTI is an advanced MRI technique that allows professionals to evaluate tissue integrity, primarily WM.…”

Section: Discussionmentioning

confidence: 99%

“…DTI is an advanced MRI technique that allows professionals to evaluate tissue integrity, primarily WM. Colpak et al [7] concluded that not only the optic chiasm but also additional WM structures in the brain were affected in patients with CRION. Moreover, their findings may reflect a more complex combination of pathological processes, rather than merely demyelination or axonal degeneration, occurring in the cerebral WM in this particular disease.…”

Section: Discussionmentioning

confidence: 99%

Chronic relapsing inflammatory optic neuropathy

Yassa

Bakbak

2018

Sisli Etfal

View full text Add to dashboard Cite

Chronic relapsing inflammatory optic neuropathy (CRION) is a form of recurrent, isolated, subacute optic neuropathy. A 33-year-old female presented at an outpatient clinic with a painful reduction of vision in the left eye that had developed 10 days earlier. The patient provided a background history of 5 similar attacks over the past 5 years. CRION was diagnosed following ophthalmological and imaging examinations, which revealed optic neuritis without demye-lination. The patient was successfully treated with steroids. The early detection of CRION is important because of the associated risk of blindness if CRION is treated inappropriately.

show abstract

White matter involvement beyond the optic nerves in CRION as assessed by diffusion tensor imaging

Abstract: WM appearing normal on brain MRI shows widespread abnormalities in a cohort of CRION patients as assessed by DTI.

Cited by 10 publications

References 25 publications

Brain Atrophy in Relapsing Optic Neuritis Is Associated With Crion Phenotype

Brain Atrophy in Relapsing Optic Neuritis Is Associated With Crion Phenotype

Influence of cigarette smoking on white matter in patients with clinically isolated syndrome as detected by diffusion tensor imaging

Chronic relapsing inflammatory optic neuropathy

Contact Info

Product

Resources

About