Comparison of 3D Double Inversion Recovery (DIR) versus 3D Fluid Attenuated Inversion Recovery (FLAIR) in precise diagnosis of acute optic neuritis

Murumkar, Vivek; Baishya, Priyanka Priyadarshini; Kulanthaivelu, Karthik; Saini, Jitender; Netravati, M.; Gupta, Rakesh K.

doi:10.1016/j.ejrad.2022.110505

Cited by 4 publications

(1 citation statement)

References 17 publications

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“…MRI imaging of optic nerve lesions may complement existing measures of optic nerve de/remyelination, described below. Double inversion recovery has emerged as a more sensitive technique for detecting acute optic neuritis compared with FLAIR 81 —which may also be less specific for inflammatory injury 82 —but none of these methods resolve inflammation, astrogliosis from myelin injury.…”

Section: Biomarkers Of Remyelinationmentioning

confidence: 99%

The Study of Remyelinating Therapies in Multiple Sclerosis: Visual Outcomes as a Window Into Repair

Zuroff,

Green

2024

Journal of Neuro-Ophthalmology

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Introduction: Amelioration of disability in multiple sclerosis requires the development of complementary therapies that target neurodegeneration and promote repair. Remyelination is a promising neuroprotective strategy that may protect axons from damage and subsequent neurodegeneration. Methods: A review of key literature plus additional targeted search of PubMed and Google Scholar was conducted. Results: There has been a rapid expansion of clinical trials studying putative remyelinating candidates, but further growth of the field is limited by the lack of consensus on key aspects of trial design. We have not yet defined the ideal study population, duration of therapy, or the appropriate outcome measures to detect remyelination in humans. The varied natural history of multiple sclerosis, coupled with the short time frame of phase II clinical trials, requires that we develop and validate biomarkers of remyelination that can serve as surrogate endpoints in clinical trials. Conclusions: We propose that the visual system may be the most well-suited and validated model for the study potential remyelinating agents. In this review, we discuss the pathophysiology of demyelination and summarize the current clinical trial landscape of remyelinating agents. We present some of the challenges in the study of remyelinating agents and discuss current potential biomarkers of remyelination and repair, emphasizing both established and emerging visual outcome measures.

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Section: Biomarkers Of Remyelinationmentioning

confidence: 99%

The Study of Remyelinating Therapies in Multiple Sclerosis: Visual Outcomes as a Window Into Repair

Zuroff,

Green

2024

Journal of Neuro-Ophthalmology

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Improving criteria for dissemination in space in multiple sclerosis by including additional regions

Foster,

Pontillo,

Davagnanam

et al. 2024

Ann Clin Transl Neurol

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ObjectiveWe investigated the effects of adding regions to current dissemination in space (DIS) criteria for multiple sclerosis (MS).MethodsParticipants underwent brain, optic nerve, and spinal cord MRI. Baseline DIS was assessed by 2017 McDonald criteria and versions including optic nerve, temporal lobe, or corpus callosum as a fifth region (requiring 2/5), a version with all regions (requiring 3/7) and optic nerve variations requiring 3/5 and 4/5 regions. Performance was evaluated against MS diagnosis (2017 McDonald criteria) during follow‐up.ResultsEighty‐four participants were recruited (53F, 32.8 ± 7.1 years). 2017 McDonald DIS criteria were 87% sensitive (95% CI: 76–94), 73% specific (50–89), and 83% accurate (74–91) in identifying MS. Modified criteria with optic nerve improved sensitivity to 98% (91–100), with specificity 33% (13–59) and accuracy 84% (74–91). Criteria including temporal lobe showed sensitivity 94% (84–98), specificity 50% (28–72), and accuracy 82% (72–90); criteria including corpus callosum showed sensitivity 90% (80–96), specificity 68% (45–86), and accuracy 85% (75–91). Criteria adding all three regions (3/7 required) had sensitivity 95% (87–99), specificity 55% (32–76), and accuracy 85% (75–91). When requiring 3/5 regions (optic nerve as the fifth), sensitivity was 82% (70–91), specificity 77% (55–92), and accuracy 81% (71–89); with 4/5 regions, sensitivity was 56% (43–69), specificity 95% (77–100), and accuracy 67% (56–77).InterpretationOptic nerve inclusion increased sensitivity while lowering specificity. Increasing required regions in optic nerve criteria increased specificity and decreased sensitivity. Results suggest considering the optic nerve for DIS. An option of 3/5 or 4/5 regions preserved specificity, and criteria adding all three regions had highest accuracy.

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Detecting optic nerve lesions in multiple sclerosis patients with a 1,5 T MRI: Evaluation of a 3D DIR sequence compared to a 2D STIR sequence

Cordt,

Larsen,

Riedel

et al. 2024

Multiple Sclerosis and Related Disorders

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Comparison of 3D Double Inversion Recovery (DIR) versus 3D Fluid Attenuated Inversion Recovery (FLAIR) in precise diagnosis of acute optic neuritis

Cited by 4 publications

References 17 publications

The Study of Remyelinating Therapies in Multiple Sclerosis: Visual Outcomes as a Window Into Repair

The Study of Remyelinating Therapies in Multiple Sclerosis: Visual Outcomes as a Window Into Repair

Improving criteria for dissemination in space in multiple sclerosis by including additional regions

Detecting optic nerve lesions in multiple sclerosis patients with a 1,5 T MRI: Evaluation of a 3D DIR sequence compared to a 2D STIR sequence

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