Leptomeningeal contrast enhancement (LMCE) on magnetic resonance imaging (MRI) is a newly recognized possible biomarker in multiple sclerosis (MS), associated with MS progression and cortical atrophy. In this study, we aimed to assess the prevalence of LMCE foci and their impact on neurodegeneration and disability. Materials. 54 patients with MS were included in the study. LMCE were detected with a 3 Tesla scanner on postcontrast fluid-attenuated inversion-recovery (FLAIR) sequence. Expanded Disability Status Scale (EDSS) score, number of relapses during 5 years from MS onset, and number of contrast-enhancing lesions on T1 weighted MRI were counted. Results. LMCE was detected in 41% (22/54) of patients. LMCE-positive patients had longer disease duration (p = 0,0098) and higher EDSS score (p = 0,039), but not a higher relapse rate (p = 0,091). No association of LMCE with higher frequency of contrast-enhancing lesions on T1-weighted images was detected (p = 0,3842). Analysis of covariates, adjusted for age, sex, and disease duration, revealed a significant effect of LMCE on the cortex volume (p = 0.043, F = 2.529), the total grey matter volume (p = 0.043, F = 2.54), and total ventricular volume (p = 0.039, F = 2.605). Conclusions. LMCE was shown to be an independent and significant biomarker of grey matter atrophy and disability in MS.
Concentrations of kappa FLC can help to define the prognosis of MS early at the disease course. Although low concentrations of FLC do not exclude a severe disease phenotype, patients with high K-FLC concentrations are at greater risk for faster MS progression, probably, due to impaired reparation of neural tissue. Measurement of FLC concentrations can be used to determine a therapeutic tactics in patients with MS.
Ишемия спинного мозга (ИСМ), или сосудистая миелопатия (G95.1 в МКБ-10),-тяжелое заболевание с острым или подострым развитием. Диагноз ИСМ устанавливается в основном клинически, а существующие методы визуализации направлены в первую очередь на исключение других причин миелопатии [1, 2]. Нарушения спинального кровообращения представляют собой серьезную социально-экономическую проблему, а относительно низкая распространенность заболевания (1-2% всех острых нарушений мозгового кровообращения или 5-8% всех миелопатий) затрудняет проведение клинических и эпидемиологических исследований, направлен-ных на разработку современных методов диагностики и лечения. Таким образом, рекомендации и руководства по ведению пациентов с ИСМ остаются в стадии разработки [3]. Этиологии в клинической картине миелоишемии посвящено достаточное количество работ, однако информации о новых методах диагностики и лечения заболевания в настоящее время не так много. В обзоре изложены современные данные о функциональной сосудистой анатомии спинного мозга (СМ), патобиохимических процессах, основных причинах ИСМ, диагностических подходах и принципах лечения.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.