Gadolinium-enhanced brain lesions in multiple sclerosis relapse ; Lesiones cerebrales captantes de gadolinio en el brote de los pacientes con esclerosis múltiple
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| Názov: | Gadolinium-enhanced brain lesions in multiple sclerosis relapse ; Lesiones cerebrales captantes de gadolinio en el brote de los pacientes con esclerosis múltiple |
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| Autori: | Martín-Aguilar, Lorena, Presas-Rodriguez, Silvia, Rovira Cañellas, Alex, Capellades, Jaume, Massuet-Vilamajó, A., Tintore Subirana, Mar, Ramió-Torrentà, Lluís |
| Prispievatelia: | Institut Català de la Salut, Martín-Aguilar L Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. Presas-Rodriguez S Multiple Sclerosis Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. Rovira À Secció de Neuroradiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Capellades J Neuroradiology Department, Hospital del Mar, Barcelona, Spain. Massuet-Vilamajó A Neuroradiology Section, Diagnostic Imaging Institute, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain. Ramió-Torrentà L Multiple Sclerosis Unit, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain. Tintoré M Servei de Neurologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus |
| Zdroj: | Scientia |
| Informácie o vydavateľovi: | Elsevier |
| Rok vydania: | 2022 |
| Predmety: | Esclerosi múltiple - Tractament, Cervell - Imatgeria per ressonància magnètica, DISEASES::Nervous System Diseases::Autoimmune Diseases of the Nervous System::Demyelinating Autoimmune Diseases, CNS::Multiple Sclerosis, Other subheadings::Other subheadings::Other subheadings::/drug therapy, ANATOMY::Nervous System::Central Nervous System::Brain, Other subheadings::Other subheadings::Other subheadings::/diagnostic imaging, ENFERMEDADES::enfermedades del sistema nervioso::enfermedades autoinmunitarias del sistema nervioso::enfermedades autoinmunes desmielinizantes del SNC::esclerosis múltiple, Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia, ANATOMÍA::sistema nervioso::sistema nervioso central::encéfalo, Otros calificadores::Otros calificadores::Otros calificadores::/diagnóstico por imagen |
| Popis: | Esclerosis múltiple; Brote; Resonancia magnética ; Esclerosi múltiple; Brot; Imatge per ressonància magnètica ; Multiple sclerosis; Outbreak; Magnetic resonance imaging ; Objective To study the clinico-radiological paradox in multiple sclerosis (MS) relapse by analyzing the number and location of gadolinium-enhanced (Gd+) lesions on brain MRI before methylprednisolone (MP) treatment. Methods We analyzed brain MRI from 90 relapsed MS patients in two Phase IV multicenter double-blind randomized clinical trials that showed the noninferiority of different routes and doses of MP administration. A 1.5- or 3-T brain MRI was performed at baseline before MP treatment and within 15 days of symptom onset. The number and location of Gd+ lesions were analyzed. Associations were studied using univariate analysis. Results Sixty-two percent of patients had at least 1 Gd+ brain lesion; the median number was 1 (interquartile range 0–4), and 41% of patients had 2 or more lesions. The most frequent location of Gd+ lesions was subcortical (41.4%). Gd+ brain lesions were found in 71.4% of patients with brainstem-cerebellum symptoms, 57.1% with spinal cord symptoms and 55.5% with optic neuritis (ON). Thirty percent of patients with brain symptoms did not have Gd+ lesions, and only 43.6% of patients had symptomatic Gd+ lesions. The univariate analysis showed a negative correlation between age and the number of Gd+ lesions (p = 0.002). Conclusion Most patients with relapse showed several Gd+ lesions on brain MRI, even when the clinical manifestation was outside of the brain. Our findings illustrate the clinico-radiological paradox in MS relapse and support the value of brain MRI in this scenario. ; Objetivo Estudiar la paradoja clínico-radiológica en el brote de la esclerosis múltiple (EM) mediante el análisis de lesiones captantes de gadolinio (Gd+) en la RM cerebral antes del tratamiento con metilprednisolona (MP). Métodos Analizamos la RM cerebral basal de 90 pacientes con EM en brote de 2 ensayos clínicos aleatorizados ... |
| Druh dokumentu: | article in journal/newspaper |
| Popis súboru: | application/pdf |
| Jazyk: | English |
| Relation: | Neurología (English Edition);37(7); https://doi.org/10.1016/j.nrleng.2021.10.005; https://hdl.handle.net/11351/8436; 000860469600006 |
| DOI: | 10.1016/j.nrleng.2021.10.005 |
| Dostupnosť: | https://hdl.handle.net/11351/8436 https://doi.org/10.1016/j.nrleng.2021.10.005 |
| Rights: | Attribution-NonCommercial-NoDerivatives 4.0 International ; http://creativecommons.org/licenses/by-nc-nd/4.0/ ; info:eu-repo/semantics/openAccess |
| Prístupové číslo: | edsbas.6FFFCDA9 |
| Databáza: | BASE |
Nájsť tento článok vo Web of Science | Abstrakt: | Esclerosis múltiple; Brote; Resonancia magnética ; Esclerosi múltiple; Brot; Imatge per ressonància magnètica ; Multiple sclerosis; Outbreak; Magnetic resonance imaging ; Objective To study the clinico-radiological paradox in multiple sclerosis (MS) relapse by analyzing the number and location of gadolinium-enhanced (Gd+) lesions on brain MRI before methylprednisolone (MP) treatment. Methods We analyzed brain MRI from 90 relapsed MS patients in two Phase IV multicenter double-blind randomized clinical trials that showed the noninferiority of different routes and doses of MP administration. A 1.5- or 3-T brain MRI was performed at baseline before MP treatment and within 15 days of symptom onset. The number and location of Gd+ lesions were analyzed. Associations were studied using univariate analysis. Results Sixty-two percent of patients had at least 1 Gd+ brain lesion; the median number was 1 (interquartile range 0–4), and 41% of patients had 2 or more lesions. The most frequent location of Gd+ lesions was subcortical (41.4%). Gd+ brain lesions were found in 71.4% of patients with brainstem-cerebellum symptoms, 57.1% with spinal cord symptoms and 55.5% with optic neuritis (ON). Thirty percent of patients with brain symptoms did not have Gd+ lesions, and only 43.6% of patients had symptomatic Gd+ lesions. The univariate analysis showed a negative correlation between age and the number of Gd+ lesions (p = 0.002). Conclusion Most patients with relapse showed several Gd+ lesions on brain MRI, even when the clinical manifestation was outside of the brain. Our findings illustrate the clinico-radiological paradox in MS relapse and support the value of brain MRI in this scenario. ; Objetivo Estudiar la paradoja clínico-radiológica en el brote de la esclerosis múltiple (EM) mediante el análisis de lesiones captantes de gadolinio (Gd+) en la RM cerebral antes del tratamiento con metilprednisolona (MP). Métodos Analizamos la RM cerebral basal de 90 pacientes con EM en brote de 2 ensayos clínicos aleatorizados ... |
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| DOI: | 10.1016/j.nrleng.2021.10.005 |