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Maranzano J, Rudko DA, Nakamura K, Cook S, Cadavid D, Wolansky L, Arnold DL, Narayanan S. MRI evidence of acute inflammation in leukocortical lesions of patients with early multiple sclerosis. Neurology 2017. [PMID: 28724581 DOI: 10.1212/wnl.0000000000004227.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To identify gadolinium-enhancing lesions affecting the cortex of patients with early multiple sclerosis (MS) and to describe the frequency and evolution of these lesions. METHODS We performed a retrospective, observational, longitudinal analysis of MRI scans collected as part of the Betaseron vs Copaxone in Multiple Sclerosis with Triple-Dose Gadolinium and 3T MRI Endpoints (BECOME) study. Seventy-five patients with early-stage MS were scanned monthly, over a period of 12-24 months, using 3T MRI after administration of triple-dose gadolinium. A total of 1,188 scans were included in the analysis. A total of 139 were selected using an image pipeline algorithm that integrated the image information from cortical gray matter masks and gadolinium-enhancing lesion masks. These scans were evaluated to identify gadolinium-enhancing lesions affecting the cortex. RESULTS The total number of gadolinium-enhancing lesions was 2,044. The number of gadolinium-enhancing lesions affecting the cortex was 120 (6%), 95% of which were leukocortical. The number of patients who showed gadolinium-enhancing lesions affecting the cortex was 27 (36%). The number of gadolinium-enhancing lesions affecting the cortex at baseline was 25 (21%) and the number of new lesions that developed in follow-up scans was 49 (41%). The number of persistent lesions was 46 (38%). CONCLUSIONS The presence of enhancing lesions affecting the cortex and adjacent white matter, although transient and not frequent, suggests that at least some cortical lesions are related to blood-brain barrier disruption. Our data support the concept that there may be an acute inflammatory phase in the development of leukocortical MS lesions. CLINICALTRIALSGOV IDENTIFIER NCT00176592.
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Affiliation(s)
- Josefina Maranzano
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington
| | - David A Rudko
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington
| | - Kunio Nakamura
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington
| | - Stuart Cook
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington
| | - Diego Cadavid
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington
| | - Leo Wolansky
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington
| | - Douglas L Arnold
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington
| | - Sridar Narayanan
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington.
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Maranzano J, Rudko DA, Nakamura K, Cook S, Cadavid D, Wolansky L, Arnold DL, Narayanan S. MRI evidence of acute inflammation in leukocortical lesions of patients with early multiple sclerosis. Neurology 2017; 89:714-721. [PMID: 28724581 DOI: 10.1212/wnl.0000000000004227] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 05/22/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To identify gadolinium-enhancing lesions affecting the cortex of patients with early multiple sclerosis (MS) and to describe the frequency and evolution of these lesions. METHODS We performed a retrospective, observational, longitudinal analysis of MRI scans collected as part of the Betaseron vs Copaxone in Multiple Sclerosis with Triple-Dose Gadolinium and 3T MRI Endpoints (BECOME) study. Seventy-five patients with early-stage MS were scanned monthly, over a period of 12-24 months, using 3T MRI after administration of triple-dose gadolinium. A total of 1,188 scans were included in the analysis. A total of 139 were selected using an image pipeline algorithm that integrated the image information from cortical gray matter masks and gadolinium-enhancing lesion masks. These scans were evaluated to identify gadolinium-enhancing lesions affecting the cortex. RESULTS The total number of gadolinium-enhancing lesions was 2,044. The number of gadolinium-enhancing lesions affecting the cortex was 120 (6%), 95% of which were leukocortical. The number of patients who showed gadolinium-enhancing lesions affecting the cortex was 27 (36%). The number of gadolinium-enhancing lesions affecting the cortex at baseline was 25 (21%) and the number of new lesions that developed in follow-up scans was 49 (41%). The number of persistent lesions was 46 (38%). CONCLUSIONS The presence of enhancing lesions affecting the cortex and adjacent white matter, although transient and not frequent, suggests that at least some cortical lesions are related to blood-brain barrier disruption. Our data support the concept that there may be an acute inflammatory phase in the development of leukocortical MS lesions. CLINICALTRIALSGOV IDENTIFIER NCT00176592.
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Affiliation(s)
- Josefina Maranzano
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington
| | - David A Rudko
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington
| | - Kunio Nakamura
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington
| | - Stuart Cook
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington
| | - Diego Cadavid
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington
| | - Leo Wolansky
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington
| | - Douglas L Arnold
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington
| | - Sridar Narayanan
- From the Department of Neurology and Neurosurgery (J.M., D.A.R., K.N., D.L.A., S.N.), Montreal Neurological Hospital and Institute, McGill University, Canada; Cleveland Clinic (K.N.), OH; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH. L.W. is currently with the University of Connecticut, School of Medicine, Farmington.
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Boudreau M, Tardif CL, Stikov N, Sled JG, Lee W, Pike GB. B 1 mapping for bias-correction in quantitative T 1 imaging of the brain at 3T using standard pulse sequences. J Magn Reson Imaging 2017; 46:1673-1682. [PMID: 28301086 DOI: 10.1002/jmri.25692] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 02/10/2017] [Indexed: 11/07/2022] Open
Abstract
PURPOSE B1 mapping is important for many quantitative imaging protocols, particularly those that include whole-brain T1 mapping using the variable flip angle (VFA) technique. However, B1 mapping sequences are not typically available on many magnetic resonance imaging (MRI) scanners. The aim of this work was to demonstrate that B1 mapping implemented using standard scanner product pulse sequences can produce B1 (and VFA T1 ) maps comparable in quality and acquisition time to advanced techniques. MATERIALS AND METHODS Six healthy subjects were scanned at 3.0T. An interleaved multislice spin-echo echo planar imaging double-angle (EPI-DA) B1 mapping protocol, using a standard product pulse sequence, was compared to two alternative methods (actual flip angle imaging, AFI, and Bloch-Siegert shift, BS). Single-slice spin-echo DA B1 maps were used as a reference for comparison (Ref. DA). VFA flip angles were scaled using each B1 map prior to fitting T1 ; the nominal flip angle case was also compared. RESULTS The pooled-subject voxelwise correlation (ρ) for B1 maps (BS/AFI/EPI-DA) relative to the reference B1 scan (Ref. DA) were ρ = 0.92/0.95/0.98. VFA T1 correlations using these maps were ρ = 0.86/0.88/0.96, much better than without B1 correction (ρ = 0.53). The relative error for each B1 map (BS/AFI/EPI-DA/Nominal) had 95th percentiles of 5/4/3/13%. CONCLUSION Our findings show that B1 mapping implemented using product pulse sequences can provide excellent quality B1 (and VFA T1 ) maps, comparable to other custom techniques. This fast whole-brain measurement (∼2 min) can serve as an excellent alternative for researchers without access to advanced B1 pulse sequences. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1673-1682.
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Affiliation(s)
- Mathieu Boudreau
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Christine L Tardif
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, Canada
| | - Nikola Stikov
- Ecole Polytechnique de Montreal, Montreal, Quebec, Canada.,Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada
| | - John G Sled
- Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Ontario, Canada
| | - Wayne Lee
- Department of Medical Biophysics, University of Toronto, Ontario, Canada
| | - G Bruce Pike
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.,Hotchkiss Brain Institute and Department of Radiology, University of Calgary, Calgary, Alberta, Canada
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Brown RA, Narayanan S, Stikov N, Cook S, Cadavid D, Wolansky L, Arnold DL. MTR recovery in brain lesions in the BECOME study of glatiramer acetate vs interferon β-1b. Neurology 2016; 87:905-11. [PMID: 27473139 DOI: 10.1212/wnl.0000000000003043] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Accepted: 05/17/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare magnetization transfer changes in new brain MRI lesions identified during monthly imaging in patients with multiple sclerosis (MS) randomized to treatment with 250 μg subcutaneous interferon-β-1b (IFN-β-1b) every other day or daily 20 mg glatiramer acetate (GA) in a post hoc study using data from the Betaseron Versus Copaxone for Relapsing Remitting or CIS Forms of MS Using Triple Dose Gad 3 T MRI (BECOME) trial. METHODS T1-weighted images acquired with and without fat saturation pulses in the BECOME study were evaluated and found to exhibit magnetization transfer ratio (MTR) effects, and were used to compute MTR images (FSMTR). Forty-three participants who had the required imaging and new lesions, from the 75 originally randomized into the BECOME study, were included in this post hoc analysis and evaluated longitudinally during treatment to determine FSMTRDrop, an experimental measure of the completeness of FSMTR recovery in new lesions. Two sets of new brain MRI lesions were defined, one based on the appearance of gadolinium contrast enhancement (Gd lesions) and the other based on FSMTR decreases (ΔFSMTR lesions). RESULTS A total of 887 Gd lesions were identified in 43 participants (19 GA, 24 IFN-β-1b) and 321 ΔFSMTR lesions in 32 participants (16 GA, 16 IFN-β-1b). Participants randomized to GA exhibited greater average postlesion FSMTR recovery than did those randomized to IFN-β-1b in both Gd (p < 0.0001) and ΔFSMTR (p < 0.0001) lesions. CONCLUSIONS New brain lesions that developed during treatment with GA exhibited evidence of greater FSMTR recovery than during treatment with IFN-β-1b. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that MTR recovery in patients with MS with new MRI brain lesions is greater with GA than with IFN-β-1b.
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Affiliation(s)
- Robert A Brown
- From the McConnell Brain Imaging Centre (R.A.B., S.N., N.S., D.L.A.), Montreal Neurological Institute and Hospital, Canada; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH.
| | - Sridar Narayanan
- From the McConnell Brain Imaging Centre (R.A.B., S.N., N.S., D.L.A.), Montreal Neurological Institute and Hospital, Canada; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH
| | - Nikola Stikov
- From the McConnell Brain Imaging Centre (R.A.B., S.N., N.S., D.L.A.), Montreal Neurological Institute and Hospital, Canada; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH
| | - Stuart Cook
- From the McConnell Brain Imaging Centre (R.A.B., S.N., N.S., D.L.A.), Montreal Neurological Institute and Hospital, Canada; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH
| | - Diego Cadavid
- From the McConnell Brain Imaging Centre (R.A.B., S.N., N.S., D.L.A.), Montreal Neurological Institute and Hospital, Canada; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH
| | - Leo Wolansky
- From the McConnell Brain Imaging Centre (R.A.B., S.N., N.S., D.L.A.), Montreal Neurological Institute and Hospital, Canada; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH
| | - Douglas L Arnold
- From the McConnell Brain Imaging Centre (R.A.B., S.N., N.S., D.L.A.), Montreal Neurological Institute and Hospital, Canada; Rutgers-New Jersey Medical School (S.C., D.C.), Newark, NJ; and Case Western Reserve University (L.W.), Cleveland, OH
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Saake M, Langner S, Schwenke C, Weibart M, Jansen O, Hosten N, Doerfler A. MRI in multiple sclerosis: an intra-individual, randomized and multicentric comparison of gadobutrol with gadoterate meglumine at 3 T. Eur Radiol 2015; 26:820-8. [PMID: 26123410 DOI: 10.1007/s00330-015-3889-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 05/28/2015] [Accepted: 06/10/2015] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To compare contrast effects of gadobutrol with gadoterate meglumine for brain MRI in multiple sclerosis (MS) in a multicentre, randomized, prospective, intraindividual study at 3 T. METHODS Institutional review board approval was obtained. Patients with known or suspected active MS lesions were included. Two identical MRIs were performed using randomized contrast agent order. Four post-contrast T1 sequences were acquired (start time points 0, 3, 6 and 9 min). If no enhancing lesion was present in first MRI, second MRI was cancelled. Quantitative (number and signal intensity of enhancing lesions) and qualitative parameters (time points of first and all lesions enhancing; subjective preference regarding contrast enhancement and lesion delineation; global preference) were evaluated blinded. RESULTS Seventy-four patients (male, 26; mean age, 35 years) were enrolled in three centres. In 45 patients enhancing lesions were found. Number of enhancing lesions increased over time for both contrast agents without significant difference (median 2 for both). Lesions signal intensity was significantly higher for gadobutrol (p < 0.05 at time points 3, 6 and 9 min). Subjective preference rating showed non-significant tendency in favour of gadobutrol. CONCLUSION Both gadobutrol and gadoterate meglumine can be used for imaging of acute inflammatory MS lesions. However, gadobutrol generates higher lesion SI. KEY POINTS Contrast-enhanced MRI plays a key role in the management of multiple sclerosis. Different gadolinium-based contrast agents are available. Number of visibly enhancing lesions increases over time after contrast injection. Gadobutrol and gadoterate meglumine do not differ in number of visible lesions. Gadobutrol generates higher signal intensity than gadoterate meglumine.
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Affiliation(s)
- Marc Saake
- Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Soenke Langner
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | | | - Marina Weibart
- Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Olav Jansen
- Department of Radiology and Neuroradiology, University of Kiel, Kiel, Germany
| | - Norbert Hosten
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Arnd Doerfler
- Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
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Arnold DL, Li D, Hohol M, Chakraborty S, Chankowsky J, Alikhani K, Duquette P, Bhan V, Montanera W, Rabinovitch H, Morrish W, Vandorpe R, Guilbert F, Traboulsee A, Kremenchutzky M. Evolving role of MRI in optimizing the treatment of multiple sclerosis: Canadian Consensus recommendations. Mult Scler J Exp Transl Clin 2015; 1:2055217315589775. [PMID: 28607695 PMCID: PMC5433339 DOI: 10.1177/2055217315589775] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 05/03/2015] [Indexed: 01/10/2023] Open
Abstract
Background Magnetic resonance imaging (MRI) is increasingly important for the early detection of suboptimal responders to disease-modifying therapy for relapsing–remitting multiple sclerosis. Treatment response criteria are becoming more stringent with the use of composite measures, such as no evidence of disease activity (NEDA), which combines clinical and radiological measures, and NEDA-4, which includes the evaluation of brain atrophy. Methods The Canadian MRI Working Group of neurologists and radiologists convened to discuss the use of brain and spinal cord imaging in the assessment of relapsing–remitting multiple sclerosis patients during the treatment course. Results Nine key recommendations were developed based on published sources and expert opinion. Recommendations addressed image acquisition, use of gadolinium, MRI requisitioning by clinicians, and reporting of lesions and brain atrophy by radiologists. Routine MRI follow-ups are recommended beginning at three to six months after treatment initiation, at six to 12 months after the reference scan, and annually thereafter. The interval between scans may be altered according to clinical circumstances. Conclusions The Canadian recommendations update the 2006 Consortium of MS Centers Consensus revised guidelines to assist physicians in their management of MS patients and to aid in treatment decision making.
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Affiliation(s)
| | - David Li
- University of British Columbia, Canada
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Burman J, Svensson E, Fransson M, Loskog ASI, Zetterberg H, Raininko R, Svenningsson A, Fagius J, Mangsbo SM. The cerebrospinal fluid cytokine signature of multiple sclerosis: a homogenous response that does not conform to the Th1/Th2/Th17 convention. J Neuroimmunol 2014; 277:153-9. [PMID: 25457841 DOI: 10.1016/j.jneuroim.2014.10.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 10/06/2014] [Accepted: 10/09/2014] [Indexed: 11/26/2022]
Abstract
In this cross-sectional study, we wanted to identify key cytokines characteristic of different stages of multiple sclerosis (MS). To this end, cerebrospinal fluid from patients with MS was investigated with a multiplexed fluorescent bead-based immunoassay. In total 43 cytokines were assessed and related to clinical and imaging data. Increased levels of CCL22, CXCL10 and sCD40L characterized relapsing-remitting MS patients with the presence of gadolinium-enhancing lesions; decreased CCL2 and increased CXCL1 and CCL5 were typical of relapsing-remitting MS patients irrespectively of the presence of gadolinium-enhancing lesions. These homogenous patterns of cytokine activation do not conform to conventional Th1/Th2/Th17 responses.
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Affiliation(s)
- Joachim Burman
- Department of Neurosciences, Uppsala University, Uppsala, Sweden; Department of Neurology, Uppsala University Hospital, Uppsala, Sweden; Department of Immunology, Genetics and Pathology, Science for Life Laboratories, Uppsala University, Uppsala, Sweden.
| | - Emma Svensson
- Department of Immunology, Genetics and Pathology, Science for Life Laboratories, Uppsala University, Uppsala, Sweden
| | - Moa Fransson
- Department of Immunology, Genetics and Pathology, Science for Life Laboratories, Uppsala University, Uppsala, Sweden
| | - Angelica S I Loskog
- Department of Immunology, Genetics and Pathology, Science for Life Laboratories, Uppsala University, Uppsala, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; UCL Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom
| | - Raili Raininko
- Department of Radiology, Uppsala University, Uppsala, Sweden
| | - Anders Svenningsson
- Department of Pharmacology and Clinical Neuroscience, Umeå University and University Hospital of Northern Sweden, Umeå, Sweden
| | - Jan Fagius
- Department of Neurosciences, Uppsala University, Uppsala, Sweden; Department of Neurology, Uppsala University Hospital, Uppsala, Sweden
| | - Sara M Mangsbo
- Department of Immunology, Genetics and Pathology, Science for Life Laboratories, Uppsala University, Uppsala, Sweden
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