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  • Articles: DFG German National Licenses  (9)
  • Multiple sclerosis  (8)
  • Key words Magnetic resonance imaging  (2)
  • 1
    ISSN: 1432-1920
    Keywords: Magnetic resonance imaging ; Magnetisation transfer ; Magnetisation transfer ratio ; Multiple sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Magnetisation transfer (MT) is a recently introduced technique for assessing the water content of tissues in vivo and its relationship to macromolecules or membranes. It has been suggested that MT could provide indirect evidence of the characteristics of multiple sclerosis (MS) lesions (oedema, demyelination, or gliosis). Our aims were to characterise brain MS lesions and to compare the magnetisation transfer ratio (MTR) values of lesions with different patterns of contrast enhancement. In patients with MS we measured the MTR of 65 gadolinium-enhancing and 292 nonenhancing lesions. Using the equation published by Dousset et al. we studied 29 patients with clinically definite MS and 10 healthy controls. Lesions had significantly lower MT than the normal-appearing white matter of the patients or the normal white matter of healthy controls. There was no difference in the MTR of enhancing and nonenhancing lesions. Enhancement was homogeneous in 45 and ring-like in 20 lesions; MTR values were lower in the latter. These findings are presumably related to the differences in pathological features of enhancing (different amounts of proteins and inflammatory cells, oedema and demyelination) and nonenhancing (gliosis, demyelination and axonal loss) lesions.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1920
    Keywords: Key words Magnetic resonance imaging ; Magnetisation transfer ; Magnetisation transfer ratio ; Multiple sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Magnetisation transfer (MT) is a recently introduced technique for assessing the water content of tissues in vivo and its relationship to macromolecules or membranes. It has been suggested that MT could provide indirect evidence of the characteristics of multiple sclerosis (MS) lesions (oedema, demyelination, or gliosis). Our aims were to characterise brain MS lesions and to compare the magnetisation transfer ratio (MTR) values of lesions with different patterns of contrast enhancement. In patients with MS we measured the MTR of 65 gadolinium-enhancing and 292 nonenhancing lesions. Using the equation published by Dousset et al. we studied 29 patients with clinically definite MS and 10 healthy controls. Lesions had significantly lower MT than the normal-appearing white matter of the patients or the normal white matter of healthy controls. There was no difference in the MTR of enhancing and nonenhancing lesions. Enhancement was homogeneous in 45 and ring-like in 20 lesions; MTR values were lower in the latter. These findings are presumably related to the differences in pathological features of enhancing (different amounts of proteins and inflammatory cells, oedema and demyelination) and nonenhancing (gliosis, demyelination and axonal loss) lesions.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1459
    Keywords: Quantitative MRI ; Disability ; Multiple sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a preliminary study, we compared by means of quantitative magnetic resonance imaging (MRI) methods (1) the T2 values and the decay characteristics of chronic brain lesions, (2) the T2 values of normal-appearing frontal white matter (NAWM) and (3) brain lesion volumes in patients with benign and secondary progressive multiple sclerosis (MS) in order to evaluate the mechanisms underlying the development of disability. Eleven clinically definite MS patients with either benign MS (n = 5) or secondary progressive MS (n = 6) were studied. Fifty-two chronic lesions (identified by comparison with MRI scans obtained at least 12 months previously) were identified. The mean T2 of large lesions (cross-sectional area greater than 41 mm2) and of the NAWM was similar in both clinical groups. However, small lesions had higher mean T2 values (P 〈 0.01) in the benign group, probably at least in part because of partial volume effects. Analysis of large lesions revealed biexponential T2 relaxation in 6 of 8 “secondary progressive” and in 2 of 16 “benign” lesions, perhaps indicating a greater degree of axonal loss in large lesions of patients with secondary progressive MS. Patients with secondary progressive MS had higher (although not significant) total and infratentorial lesion loads than those of the benign group. These preliminary findings suggest, but do not establish, that variations in the extent, site and pathological nature of lesions may all contribute to different patterns of disease evolution in MS.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1459
    Keywords: Acute myelopathy ; Magnetic resonance imaging ; Evoked potentials ; Multiple sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Brain and spinal cord magnetic resonance imaging (MRI), multimodal evoked potentials (EPs) and cerebrospinal fluid (CSF) analysis were performed in 27 patients with acute myelopathy of unknown aetiology (AMUA), to detect the diagnostic and prognostic values of paraclinical tests at presentation. Spinal cord MRI was abnormal in 56% and brain MRI in 33% of the patients. Visual EPs were abnormal in 7%, median somatosensory EPs in 17%, tibial somatosensory EPs in 56% and motor EPs in 35% of the cases examined. Brain-stem acoustic EPs were normal in all the patients. CSF oligoclonal bands (OBs) were detected in 30% of cases. The patients were divided into subgroups according to the short-term clinical outcome (complete, partial or absent recovery). There were no significant differences among the three groups as regards MRI findings. Patients with complete recovery showed a significantly lower frequency of tibial somatosensory EP and motor EP abnormalities. According to the paraclinical findings at onset and on the basis of a long-term clinical follow-up (mean duration 24 months), 6 patients were diagnosed as having clinically definite multiple sclerosis, while 21 did not develop further neurological disturbances. Only the presence of CSF OBs was significantly more frequent in patients with definite multiple sclerosis. Our study indicates that EPs exploring spinal cord function are more powerful than spinal MRI for predicting the short-term outcome of AMUA, while the combined use of brain MRI and CSF OBs has the highest negative predictive value for the subsequent development of clinically definite multiple sclerosis.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1459
    Keywords: Multiple sclerosis ; Myelopathy ; Magnetic resonance imaging ; Evoked potentials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Brain magnetic resonance imaging (MRI), multimodality evoked potentials (EPs) and cerebrospinal fluid examination were performed in 42 patients with myelopathy of undetermined aetiology in order to detect abnormalities usually related to multiple sclerosis (MS). Patients were divided into three groups: insidious-onset myelopathy with only motor signs (group A; 11 patients), with both motor and sensory signs (group B; 18 patients) and acute-onset myelopathy (group C; 13 patients). Multiple brain MRI lesions were found in 18 patients (2 of group A, 13 of group B and 3 of group C). Another 7 patients had a single white-matter lesion. Visual EPs were abnormal in 21 and brain-stem auditory EPs in 12 patients. Paraclinical tests supported the diagnosis of MS in 25 patients (60%) by showing subclinical brain abnormalities. Oligoclonal bands were found in 16 of these 25 patients. The findings strongly suggest a diagnosis of MS in the patients of group B.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-1459
    Keywords: Multiple sclerosis ; Diagnosis ; Electrophysiological tests ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Sixty multiple sclerosis (MS) patients (33 definite, 13 probale and 14 suspected were investigated by computed tomography (CT), magnetic resonance imaging (MRI), multimodality evoked potentials (EPs) and cerebrospinal fluid (CSF) electrophoresis. MRI abnormalities were found in 50 cases, while at least one abnormal evoked potential was detected in each of 52 cases. Brain-stem auditory evoked potentials were more sensitive than MRI for the detection of brainstem involvement. All the patients with oligoclonal bands had abnormal MRI and none of the patients with normal MRI had oligoclonal bands in the CSF. The number and the extent of MRI lesions were significantly correlated with the duration of disease and with the degree of disability. Our observations stress the importance of the combined use of MRI and EPs in detecting silent CNS lesions in MS patients.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1459
    Keywords: Key words Magnetic resonance imaging ; Turbo spin echo ; Fast fluid attenuated inversion recovery ; Systemic autoimmune diseases ; Brain lesions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fast fluid-attenuated inversion recovery (fFLAIR) is more sensitive that conventional or fast spin echo T2-weighted magnetic resonance imaging (MRI) for detecting lesions in the brain of patients with ischemic, inflammatory, or demyelinating diseases of the CNS. We ¶investigated whether the use of fFLAIR also increases the sensitivity of brain MRI assessment in patients with systemic autoimmune disorders. Turbo spin echo (TSE) dual-echo and fFLAIR scans of the brain were obtained from patients affected by systemic lupus erythematosus (SLE) with (NSLE, n = 9) and without clinical CNS involvement (n = 15), Behçet disease (n = 5), Wegener granulomatosis (n = 9), and antiphospholipid antibody syndrome (n = 6). Brain hyperintense lesions were counted and classified according to their size and their location by two observers by consensual agreement. The total lesion volume was measured using a semiautomated technique for lesion segmentation on both TSE and fFLAIR scans. The imaging modalities showed brain hyperintense lesions in all 9 SLE patients with CNS involvement, 5 of 15 SLE patients without CNS involvement, 5 of 9 patients with Wegener granulomatosis, 1 of 5 with Behçet disease, and 3 of 6 with antiphospholipid antibody syndrome. ¶A total of 342 lesions were seen on both sequences; 88 were seen only on TSE and 54 only on fFLAIR scans. The average number of brain lesions per scan was higher on TSE than on fFLAIR, since significantly more discrete (P 〈 0.002) and small (P = 0.004) lesions were seen on TSE than on fFLAIR. The median total lesion volume, however, was similar on TSE and fFLAIR. Our study indicates that the use of fFLAIR does not improve the sensitivity of fast dual-echo MRI for detecting brain abnormalities in patients with systemic autoimmune disorders.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Neurological sciences 19 (1998), S. S399 
    ISSN: 1590-3478
    Keywords: Multiple sclerosis ; Magnetic resonance imaging ; Cognitive functions ; Magnetization transfer imaging Frontal lobe
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario In questa revisione della letteratura, vengono presentati e discussi i risultati di recenti studi di risonanza magnetica (RM) quantitativa nei quali il grado di deficit cognitivo in pazienti affetti da sclerosi multipla e stato correlato con l'estensione e la gravity delle alterazioni encefaliche evidenziate con tecniche differenti di RM, al fine di raggiungere una migliore comprensione dei meccanismi patogenetici sottesi allo sviluppo di tall deficit.
    Notes: Abstract In this review, the results of recent quantitative magnetic resonance imaging (MRI) studies correlating the degree of cognitive impairment in multiple sclerosis patients with the extent and severity of brain abnormalities seen using MRI techniques are presented and discussed with the ultimate goal of a better understanding of the pathophysiological mechanisms underlying the development of such deficits.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1590-3478
    Keywords: Multiple sclerosis ; EEG ; Coherence Movement-related potentials ; Reaction time ; Cognitive impairment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Il coinvolgimento cognitivo è una frequente complicanza della sclerosi multipla (SM), generalmente come demenza sottocorticale. Al fine di valutare le connessioni funzionali cortico-corticali nella SM, abbiamo studiato la coerenza dell'elettroencefalogramma (EEG) in un gruppo di 21 pazienti con SM clinicamente deftnita. I pazienti sono stati inoltre sottoposti a risonanza magnetica (RM) e valutazione neuropsicologica. I pazienti con deficit cognitivi presentavano, rispetto ai pazienti senza deficit, una riduzione della coerenza di banda alfa e theta, nelle derivazioni a breve e a lunga distanza. La coerenza anteroposteriore ed interemisferica era significativamente correlata col cortco lesionale RM immediatamente sottostante la corteccia e non con le lesioni periventricolari. Questi dati supportano l'ipotesi the il coinvolgimento cognitivo nella sclerosi multipla sia principalmente correlato a demielinizzazione o perdita assonale delle connessioni cortico-corticali. In un altro studio abbiamo valutato i correaaai neuropsicologici dei deficit frontali. I lobi frontali hanno un ruolo fondamentale nella programmazione ed esecuzione del movimento. Abbiamo valutato il potenziale movimento-correlato (MRP) in pazienti SM con e senza deficit frontali. Il tempo di reazione manuale al test di Stroop, the valuta le funzioni esecutive, e le componenti del MRP erano ritardate in entrambi i gruppi di pazienti rispetto ai soggetti normali e nei pazienti frontali rispetto ai non frontali. Questi dati suggeriscono the il coinvolgimento cognitivo frontale nella SM corrisponde a un'alterazione dell'attività bioelettrica anche durante un compito motorio semplice.
    Notes: Abstract Cognitive impairment is a frequent complication of multiple sclerosis (MS), generally reflecting subcortical dementia. In order to explore functional cortico-cortical connections in MS, we studied electroencephalogram (EEG) coherence in a group of 21 clinically defined MS patients. Patients also underwent magnetic resonance imaging (MRI) and neuropsychological examinations. Compared to unimpaired MS patients, cognitively involved patients had reduced short-distance and long-distance theta and alpha band coherencies. Anteroposterior and interhemispheric coherencies were significantly correlated with MRI lesion load immediately underlying cortex but not were exclusively associated with periventricular lesions. These data support the hypothesis that cognitive impairment in MS is mostly related to demyelination or axonal loss of cortico-cortical connections. In a second study, we evaluated the neurophysiological correlates of frontal lobe dysfunction. Frontal lobes are also involved in motor planning and execution. We evaluated the EEG movement-related potential (MRP) in MS patients with and without frontal neuropsychological deficits. Reaction times to the Stroop test, which evaluates frontal functions, and MRP components were delayed in both MS groups compared to normal subjects and in frontal compared to nonfrontal MS patients. These data suggest that frontal cognitive involvement in MS corresponds to abnormal bioelectrical activity also during simple motor tasks.
    Type of Medium: Electronic Resource
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