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  • 1
    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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  • 2
    ISSN: 1432-1920
    Keywords: Key words Magnetic resonance imaging ; Multiple sclerosis ; Pulse sequences ; Lesion load
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Changes on serial assessments of brain MRI lesion load are used for monitoring therapeutic efficacy in patients with multiple sclerosis (MS). We assessed the accuracy and reliability of conventional spin-echo (CSE) and fast spin-echo (FSE) sequences for measurement of lesion volume using a semiautomated contour technique. Cranial CSE and FSE examinations of 18 patients with secondary progressive MS were studied. The mean lesion load was slightly higher with the CSE sequence (p = 0.002). Intraobserver variability was significantly higher for FSE than for CSE, according to both the coefficient of variation between two measurements (mean 2.48 % and 1.35 % respectively, p 〈 0.05) and back-transformed 95 % limits of agreement (1.005–1.060 for FSE; 0.988–1.019 for CSE). Although FSE sequences are quicker and the total lesion volume measurements are similar to those obtained with CSE, the poorer reproducibility raises doubts about the use of FSE to replace CSE in clinical trials.
    Type of Medium: Electronic Resource
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  • 3
    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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