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  • 11
    ISSN: 0009-2614
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Chemistry and Pharmacology , Physics
    Type of Medium: Electronic Resource
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  • 12
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Cell Differentiation and Development 27 (1989), S. 126 
    ISSN: 0922-3371
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology
    Type of Medium: Electronic Resource
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  • 13
    Electronic Resource
    Electronic Resource
    Springer
    Neurological sciences 14 (1993), S. 333-336 
    ISSN: 1590-3478
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 14
    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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  • 15
    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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  • 16
    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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  • 17
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Magnetic resonance imaging ; Magnetisation tranfer imaging ; Spinal cord ; Measurement ; reproducibility
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract New magnetic resonance (MR) measures considered to be putative markers of demyelination and axonal loss were found to be more closely related to clinical disability than T2-weighted MR imaging (MRI) findings in patients with multiple sclerosis (MS). In this study, we evaluated the reproducibility of such measurements in order to assess their reliability for longitudinal studies in MS. The intra-observer coefficients of variation for repeated measurements did not significantly differ among the MR techniques studied [2.6% for T2-weighted MRI, 4.38% for unenhanced T1-weighted MRI, 3.65% for magnetisation transfer imaging (MTI) and 2.28% for spinal cord cross-sectional area at C5]. Our findings suggest that non-conventional MR techniques may be reliable outcome measures for clinical trials in MS.
    Type of Medium: Electronic Resource
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  • 18
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Brain magnetic resonance imaging ; Repositioning ; Clinical trials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to assess the variability of lesion load measurements for repeated brain magnetic resonance imaging (MRI) scans judged to have either poor or good repositioning quality on the basis of subjective criteria used for clinical trials in multiple sclerosis (MS). Scan-rescan variability was also compared with the intra-observer variability assessed from three repeated volume measurements of the same scan. Nine patients with MS were studied; each of them underwent the scan-rescan procedure on the same day. Five scans were considered to have poor and four scans to have good repositioning. Between these two groups there were no differences in either the mean lesion loads or the measurement variance. For the whole group of patients, the intra-observer variability of repeated measurements gave a significantly lower coefficient of variation (COV=4.9%) than the variability owing to repositioning (COV=8.9%, P〈0.01, F test). Our results confirm that the effect of repositioning on brain MRI lesion load assessment is stronger than that owing to the intra-observer variability for repeated measurements and indicate that the simple visual judgment about the scan repositioning quality seems unable to predict the scan-rescan reproducibility.
    Type of Medium: Electronic Resource
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  • 19
    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
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  • 20
    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
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