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  • 1
    Electronic Resource
    Electronic Resource
    High-dose contrast-enhanced MRI in multiple sclerosis (1996)
    Springer
    Neuroradiology 38 (1996), S. S5 
    Details
    ISSN: 1432-1920
    Keywords: Multiple sclerosis ; High-dose contrast-enhanced ; magnetic resonance imaging ; Gadolinium-DTPA ; Gadolinium-HP-D03A
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Contrast-enhanced MRI is effective for assessing disease activity in multiple sclerosis (MS) and may provide an outcome measure for testing the efficacy of treatment in clinical trials. To compare the sensitivity of high-dose gadolinium-HP-D03A with that of a standard dose of gadolinium-DTPA, we studied 16 patients with relapsing-remitting MS in the acute phase of the disease. Each underwent two MRI examinations within at most 48 h. The initial MRI study was with a standard dose of gadolinium-DTPA (0.1 mmol/kg), and the second one an experimental dose of gadolinium-HP-D03A (0.3 mmol/kg). No adverse effects were attributed to the contrast media. The high-dose study revealed more enhancing lesions than the standard-dose study (56 vs 38). This difference was found to be more relevant for infratentorial and small lesions. Furthermore, with the higher dose, there was a marked qualitative improvement in the visibility and delineation of the lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02278110
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    High-dose contrast-enhanced MRI in multiple sclerosis (1996)
    Springer
    Neuroradiology 38 (1996), S. S5 
    Details
    ISSN: 1432-1920
    Keywords: Key words Multiple sclerosis ; High-dose contrast-enhanced magnetic resonance imaging ; Gadolinium-DTPA ; Gadolinium-HP-DO3A
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Contrast-enhanced MRI is effective for assessing disease activity in multiple sclerosis (MS) and may provide an outcome measure for testing the efficacy of treatment in clinical trials. To compare the sensitivity of high-dose gadolinium-HP-DO3A with that of a standard dose of gadolinium-DTPA, we studied 16 patients with relapsing-remitting MS in the acute phase of the disease. Each underwent two MRI examinations within at most 48 h. The initial MRI study was with a standard dose of gadolinium-DTPA (0.1 mmol/kg), and the second one an experimental dose of gadolinium-HP-DO3A (0.3 mmol/kg). No adverse effects were attributed to the contrast media. The high-dose study revealed more enhancing lesions than the standard-dose study (56 vs 38). This difference was found to be more relevant for infratentorial and small lesions. Furthermore, with the higher dose, there was a marked qualitative improvement in the visibility and delineation of the lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050909
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Multiple sclerosis: interobserver agreement in reporting active lesions on serial brain MRI using conventional spin echo, fast spin echo, fast fluid-attenuated inversion recovery and post-contrast T1-weighted images (1999)
    Springer
    Journal of neurology 246 (1999), S. 920-925 
    Details
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Magnetic resonance imaging ; Disease activity ; Fast spin echo ; Fast fluid-attenuated inversion ; recovery ; Reproducibility
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Previous studies have addressed the question of the precision in assessing multiple sclerosis (MS) activity by counting enhancing lesions on gadolinium enhanced brain magnetic resonance imaging (MRI). However, counting the active lesions on serial unenhanced MRI obtained by various pulse sequences has not been yet considered. We compared the interobserver levels of agreement in reporting active MS lesions on serial enhanced and unenhanced MRI to assess whether the use of various unenhanced techniques may change the degree of interobserver measurement reproducibility. Dual-echo conventional spin echo (CSE), dual-echo fast spin echo (FSE), fast fluid-attenuated inversion recovery (FLAIR) and Gd-enhanced T1-weighted brain MRI were obtained from five MS patients at baseline and monthly for 2 months. Six experienced observers independently identified and counted active MS lesions on the two follow-up MRI scans. Active lesions were considered to be all the enhancing lesions and any new or enlarging lesion on enhanced and unenhanced scans. Interobserver levels of agreement were calculated by weighted κ values. Very good agreement was reached only for counting total and new Gd-enhancing lesions. Good agreement was achieved for counting new lesions on the three unenhanced techniques, whereas the agreement for counting enlarging lesions was poor with all the MRI techniques. The level of agreement was significantly heterogeneous for various MRI techniques but not for various lesion sites. These results confirm that counting enhancing lesions is the most reliable method for assessing MS activity, but the use of any of the available unenhanced MRI techniques did not result in different levels of interobserver agreement when reporting new and enlarging MS lesions on serial scans.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150050483
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Randomized placebo-controlled trial of mitoxantrone in relapsing-remitting multiple sclerosis: 24-month clinical and MRI outcome (1997)
    Springer
    Journal of neurology 244 (1997), S. 153-159 
    Details
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Mitoxantrone ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We designed a randomized, placebo-controlled, multicentre trial involving 51 relapsing-remitting multiple sclerosis patients to determine the clinical efficacy of mitoxantrone treatment over 2 years. Patients were allocated either to the mitoxantrone group (27 patients receiving IV infusion of mitoxantrone every month for 1 year at the dosage of 8 mg/m2) or to the placebo group (24 patients, receiving IV infusion of saline every month for 1 year) using a centralized randomization system. Disability at entry and at 12–24 months was evaluated by four blinded neurologists trained in the application of the Kurtzke Expanded Disability Scale (EDSS). In addition, the number and clinical characteristics of the exacerbations over the 24 months were recorded by the local investigators. MRI, at 0,12 and 24 months, was performed with a 0.2 T permanent unit. MRI data were analysed by two blinded neuroradiologists. All patients underwent a clinical evaluation. A statistically significant difference in the mean number of exacerbations was observed between the mitoxantrone group and placebo group both during the 1st and the 2nd year. Although there was no statistically significant benefit in terms of mean EDSS progression over 2 years, the proportion of patients with confirmed progression of the disease, as measured by a one point increase on the EDSS scale, was significantly reduced at the 2nd year evaluation in the mitoxantrone group. Forty-two (23 mitoxantrone, 19 placebo) patients underwent all MRI examinations during the 24-month period. We observed a trend towards a reduction in the number of new lesions on T2-weighted images in the mitoxantrone group. Our study suggests that mitoxantrone might be effective in reducing disease activity, both by decreasing the mean number of exacerbations and by slowing the clinical progression sustained by most patients after 1 year from the end of treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150050066
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Fatigue and magnetic resonance imaging activity in multiple sclerosis (1999)
    Springer
    Journal of neurology 246 (1999), S. 454-458 
    Details
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Fatigue ; Magnetic resonance ; imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fatigue is a frequent and often severe symptom in multiple sclerosis. Pathogenic mechanisms proposed for fatigue include the release of proinflammatory cytokines, which is thought to have an important effect on changes in the blood-brain barrier (BBB). To investigate whether fatigue is related to BBB disruption we studied 11 relapsing-remitting MS patients participating in a multicenter longitudinal study comparing the sensitivity of monthly enhanced magnetic resonance imaging (MRI) after standard-dose and triple-dose injection of gadolinium-diethylene triaminopentoacetic acid (Gd-DTPA). Serial Gd-enhanced MRI studies were performed in two separate sessions every 4 weeks for 3 months. An expanded version of the Fatigue Severity Scale, including 29 items, was administered 24 h before each MRI examination. No relationship was found between the number and volume of Gd-enhancing lesions and fatigue scores at any monthly examination over the study period. Furthermore changes in MRI activity were not significantly related to changes in fatigue scores. These results were obtained on triple-dose delayed scanning, which is more sensitive than standard-dose scanning in detecting areas of BBB disruption. Our preliminary results thus do not support the hypothesis of a relationship between BBB alterations and fatigue severity in multiple sclerosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150050382
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    Paper (German National Licenses)
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  • 6
    Electronic Resource
    Electronic Resource
    Disease activity in multiple sclerosis studied by weekly triple-dose magnetic resonance imaging (1999)
    Springer
    Journal of neurology 246 (1999), S. 689-692 
    Details
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Magnetic resonance imaging ; Gadolinium-DTPA ; Triple dose ; Blood-brain barrier
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study assessed whether dysfunction of the blood-brain barrier is an obligatory early event in lesion formation in multiple sclerosis. Dual-echo and T1-weighted magnetic resonance imaging after the injection of a triple dose (0.3 mmol/kg) of gadolinium-DTPA were obtained from ten patients with relapsing-remitting multiple sclerosis every week for 2 months. Sixty-four newly active lesions were detected by the two techniques. All the 44 new lesions seen on dual-echo scans enhanced during the early phases of their formation: 33 at their first appearance, 10 1 week before their appearance on the dual-echo scans, and one the week thereafter. When the every fourth (monthly) scan was analyzed, a total of 55 newly active lesions were detected (i.e., 14% active lesions would have been missed compared to the number found on weekly scanning). Thirty-one of them were detected by both dual-echo and triple-dose scans, 15 only by enhanced scans, and nine only by dual-echo scans. This study confirms that with highly sensitive magnetic resonance imaging techniques dysfunction of the blood-brain barrier is an obligatory early event in new lesion formation in relapsing-remitting multiple sclerosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150050433
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    Paper (German National Licenses)
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  • 7
    Electronic Resource
    Electronic Resource
    The use of magnetic resonance imaging in multiple sclerosis treatment trials: power calculations for annual lesion load measurement (2000)
    Springer
    Journal of neurology 247 (2000), S. 34-40 
    Details
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Treatment trial ; Power calculations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Phase III definitive treatment trials of new multiple sclerosis (MS) therapies now routinely incorporate an annual magnetic resonance imaging protocol, with change in T2-weighted brain lesion load providing an important outcome measure. To date the accepted strategy has been to perform a core imaging protocol on all patients in such studies. The aim of this study was to provide power calculations based on this MRI endpoint. Serial MRI data from 128 patients with either relapsing remitting (RR) or secondary progressive (SP) MS were used to calculate sample size requirements using a repeated measures analysis of variance design. We provide sample size calculations based on various follow-up intervals and effect sizes. Sample sizes for the SPMS cohort were substantially larger than for the RRMS group, reflecting the greater variance in lesion load changes between patients in the SPMS group. With a follow-up of 3 years, we estimate that only 12 and 33 patients per arm are needed to show stabilisation of MRI lesion load in the RRMS and SPMS groups, respectively. Our results suggest that ongoing phase III treatment trials are more than adequately powered to detect even subtle treatment effects, and indicate that incorporating measurements from longer follow-up durations increases power substantially. We conclude that an annual imaging protocol provides a robust and powerful tool for assessing effects on the radiological appearance of the disease process.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150050007
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    Paper (German National Licenses)
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  • 8
    Electronic Resource
    Electronic Resource
    Four-year follow-up of a case of acute multiple sclerosis of the Marburg type (1997)
    Springer
    Neurological sciences 18 (1997), S. 163-166 
    Details
    ISSN: 1590-3478
    Keywords: Marburg's disease ; Multiple sclerosis ; Neuroimaging ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Descriviamo il decorso clinico, la terapia e i quadri di risonanza magnetica durante un periodo di quattro anni di una paziente affetta da sclerosi multipla acuta tipo Marburg, trattata con steroidi e mannitolo, che sopravvisse al primo attacco. Sebbene il decorso clinico era simile ad una forma remittente di sclerosi multipla, il nostro caso si caratterizzava per la necessità di una protratta terapia steroidea e per la tendenza delle lesioni presenti alla risonanza magnetica di risolversi completamente.
    Notes: Abstract We describe the clinical course, treatment and magnetic resonance findings during a four-year follow-up of a patient with acute multiple sclerosis of the Marburg type, treated with steroid and mannitol therapy, who survived the first bout. Although the course of the disease was clinically indistinguishable from relapsing-remitting multiple sclerosis, our case was characterized by peculiar features. These included the need for protracted steroid therapy and the remarkable tendency of MRI lesions to resolve completely.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02048485
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    Paper (German National Licenses)
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  • 9
    Electronic Resource
    Electronic Resource
    Irreversible total blindness in multiple sclerosis (1991)
    Springer
    Neurological sciences 12 (1991), S. 327-329 
    Details
    ISSN: 1590-3478
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02337782
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    Paper (German National Licenses)
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