Gadolinium-enhanced brain lesions in multiple sclerosis relapse

Objective: To study the clinico-radiological paradox in multiple sclerosis (MS) relapse by analyzing the number and location of gadolinium-enhanced (Gd+) lesions on brain MRI before methylprednisolone (MP) treatment. Methods: We analyzed brain MRI from 90 relapsed MS patients in two Phase IV multice...

Descripción completa

Detalles Bibliográficos
Autores: Martín Aguilar, Lorena, Presas Rodríguez, Silvia, Rovira, Àlex, Capellades, Jaume, Massuet Vilamajó, Anna, Ramió Torrentà, Lluís, Tintoré, Mar, Brieva Ruiz, Luis, Moral, Ester, Cano Orgaz, Antonio, Blanco, Yolanda, Batlle Nadal, Jordi, Carmona, Olga, Gea Sánchez, Montserrat, Hervás, J.V., Ramo Tello, Cristina
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Universitat de Lleida (UdL)
Repositorio:Repositori Obert UdL
OAI Identifier:oai:repositori.udl.cat:10459.1/72708
Acceso en línea:https://doi.org/10.1016/j.nrl.2021.10.005
http://hdl.handle.net/10459.1/72708
Access Level:acceso abierto
Palabra clave:Multiple Sclerosis
Relapse
MRI
Gadolinium enhancement
Esclerosis múltiple
Brote
Resonancia magnética
Lesiones captantes de gadolinio
Descripción
Sumario:Objective: To study the clinico-radiological paradox in multiple sclerosis (MS) relapse by analyzing the number and location of gadolinium-enhanced (Gd+) lesions on brain MRI before methylprednisolone (MP) treatment. Methods: We analyzed brain MRI from 90 relapsed MS patients in two Phase IV multicenter double-blind randomized clinical trials that showed the noninferiority of different routes and doses of MP administration. A 1.5- or 3-T brain MRI was performed at baseline before MP treatment and within 15 days of symptom onset. The number and location of Gd+ lesions were analyzed. Associations were studied using univariate analysis Results: Sixty-two percent of patients had at least 1 Gd+ brain lesion; the median number was 1 (interquartile range 0—4), and 41% of patients had 2 or more lesions. The most frequent location of Gd+ lesions was subcortical (41.4%). Gd+ brain lesions were found in 71.4% of patients with brainstem-cerebellum symptoms, 57.1% with spinal cord symptoms and 55.5% with optic neuritis (ON). Thirty percent of patients with brain symptoms did not have Gd+ lesions, and only 43.6% of patients had symptomatic Gd+ lesions. The univariate analysis showed a negative correlation between age and the number of Gd+ lesions (p = 0.002) Conclusion: Most patients with relapse showed several Gd+ lesions on brain MRI, even when the clinical manifestation was outside of the brain. Our findings illustrate the clinico-radiological paradox in MS relapse and support the value of brain MRI in this scenario.

Similares en LA Referencia