Evidence for axonal pathology and adaptive cortical reorganization in patients at presentation with clinically isolated syndromes suggestive of multiple sclerosis

Rocca, Maria A.; Mezzapesa, Domenico Maria; Falini, Andrea; Ghezzi, Angelo; Martinelli, Vittorio; Scotti, Giuseppe; Comı, Gıancarlo; Filippi, Massimo

doi:10.1016/s1053-8119(03)00043-0

Cited by 135 publications

(94 citation statements)

References 48 publications

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“…In patients with MS, axonal loss is reported in the early stages of the disease, including CIS, and is associated with irreversible damage and incomplete recovery [26][27][28][29]. Studies with optic coherence tomography have demonstrated axonal loss in the retinal nerve fiber layer in patients with MS in the early stages of the disease [30][31][32].…”

Section: Discussionmentioning

confidence: 99%

Risk of multiple sclerosis after optic neuritis in patients with normal baseline brain MRI

Marques

Matias

Silva

et al. 2014

Journal of Clinical Neuroscience

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a b s t r a c tWhen assessing and managing a patient with optic neuritis (ON), the risk of future development of multiple sclerosis (MS) is an important issue, as this can be the first presentation of the disease. Although the presence of lesions on baseline brain MRI is the strongest predictor of MS conversion, some patients with normal imaging also develop MS. We aimed to estimate MS risk in patients with ON and a normal baseline MRI and identify individuals with higher risk of conversion. We performed a retrospective study including patients with idiopathic ON and normal baseline brain MRI who presented to our hospital over an 8 year period. Of a total of 42 patients, 10 converted to MS: five during the first follow-up year, seven during the first 2 years and all of the patients within the first 5 years, with a 5 year MS conversion rate of 23.8%. MS conversion rates were significantly higher in patients with history of previous symptoms suggestive of demyelination (p = 0.002), cerebrospinal fluid oligoclonal bands unmatched in serum (p = 0.004) and incomplete visual acuity recovery (66/12) after 1 year (p = 0.002). Lower conversion rates were found in patients with optic disc edema (p = 0.022). According to these results, a significant proportion of patients with idiopathic ON and a normal baseline brain MRI will develop MS, with a higher risk during the first 5 years. Therefore, in the presence of factors in favor of MS conversion, close follow-up, including semestral medical consultations and yearly brain MRI, can be recommended. Early immunomodulatory treatment may be individually considered as it can delay conversion and reduce new lesion development rate.

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Section: Discussionmentioning

confidence: 99%

Risk of multiple sclerosis after optic neuritis in patients with normal baseline brain MRI

Marques

Matias

Silva

et al. 2014

Journal of Clinical Neuroscience

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“…8,11,[15][16][17][18][19][20][21][22] An increased recruitment of several brain areas with increasing T2 lesion volume (LV) has been shown in patients with RRMS 9,11,23 and primary progressive (PP) MS. Also, the severity of intrinsic T2 lesion damage, measured using T1-weighted images, 24 magnetization transfer (MT), and diffusion tensor (DT) MRI, 19 has been found to modulate the activity of some brain areas. …”

Section: Correlations Between Brain Functional Reorganization and Smentioning

confidence: 99%

Functional MRI in investigating cognitive impairment in multiple sclerosis

Rocca

Meo²,

Filippi

2016

Acta Neurol Scand

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“…The MPFC, associated with mentalizing tasks, activates whenever the person is attending to certain states of the self or others. The MPFC is equally active when the person is engaged in true beliefs, knowledge of the world based on past experience applied to the current situation, and partially in personal observations and behavioural predictions (STS) [48] There is increasing evidence of functional cortical changes in the early stages of MS, even after a single clinical episode [138,139], when expansion and recruitment of additional cortical fields as common compensation of brain damage are registered [112].…”

Section: Discussionmentioning

confidence: 99%

Social Cognition Impairments in Patients with Multiple Sclerosis and Comparison with Imaging Studies, Disease Duration and Grade of Disability

Ignatova¹,

Todorova²,

Surchev³

2016

Trending Topics in Multiple Sclerosis

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Cognitive impairments in multiple sclerosis (MS) are heterogeneous and their rate varies between 43% and 70%. A less studied aspect of cognition is social cognition, which is not a uniform theoretical construct. It includes emotion perception, prosody, empathy, theory of mind (ToM) and assessment of mood. In addition to progressive physical disability, social cognitive impairments are a reason for job loss in 24-80% of patients with MS, increased divorce rate, dissolution of partnerships and social communication difficulties.Social cognitive impairments are the result of disruptions in the mentalization network at the neuroanatomical, neurochemical and/or genetic level, which can lead to malfunctions in the dopaminergic-serotoninergic system and to compromising the development of neuroanatomical targets within the network. The wide dissemination of demyelinating lesions and cortical thinning typical of patients with MS often lead to anatomic and functional disorders of the above-mentioned specific brain structures. A correlation has been established among specific cortical areas involved in emotion identification from facial expression (right and left fusiform face area, frontal eye), emotion processing (right entorhinal cortex) and socially relevant information (left temporal pole). The most active brain region involved in social cognitive processing is the medal frontal cortex (MFC), which is described as the brain's social cognitive center. During performance of various sociocognitive tasks for mental state attribution, common areas of increased activation in the medial prefrontal gyrus and the temporoparietal junctions are registered bilaterally, while the area of the medial prefrontal cortex (the paracingulate cortex) is the only region uniquely activated by the performance of ToM.Most MRI studies of patients with MS found a correlation between the cognitive and/or affective disorders, on the one hand, and lesion localization, total lesion load, or cerebral atrophy, on the other. A significant correlation was also reported between © 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.abnormal activities in specific cortical zones on fMRI, on the one hand, and clinical manifestation, conventional MRI findings and behavioral changes, on the other. Altered patterns of brain activity were found in all clinical phenotypes of MS, including when cognitive abilities were intact and/or restored, social cognitive dysfunction in MS actually affects all stages of the disease and all types of clinical course. The cortical plastic changes are a dynamic phenomenon that can be modulated by external factors. This phenomenon would facilitate the mapping of individual strategies for adequate treatment and rehabilitation of each patient.

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Evidence for axonal pathology and adaptive cortical reorganization in patients at presentation with clinically isolated syndromes suggestive of multiple sclerosis

Cited by 135 publications

References 48 publications

Risk of multiple sclerosis after optic neuritis in patients with normal baseline brain MRI

Risk of multiple sclerosis after optic neuritis in patients with normal baseline brain MRI

Functional MRI in investigating cognitive impairment in multiple sclerosis

Social Cognition Impairments in Patients with Multiple Sclerosis and Comparison with Imaging Studies, Disease Duration and Grade of Disability

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