Identical lesion morphology in primary progressive and relapsing–remitting MS –an ultrahigh field MRI study

Kuchling, Joseph; Ramien, Caren; Bozin, Ivan; Dörr, Jan; Harms, Lutz; Rosche, Berit; Niendorf, Thoralf; Paul, Friedemann; Sinnecker, Tim; Wuerfel, Jens

doi:10.1177/1352458514531084

Cited by 41 publications

(39 citation statements)

References 15 publications

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“…The proportion of total lesions with a central vein was not related to the clinical phenotype -a finding that was also supported by another study 32 . However, when lesions were classified according to their location, the authors reported that central veins were most prevalent in periventricular lesions (94%).…”

Section: The Central Vein In Ms Discussionsupporting

confidence: 70%

“…This first in vivo demonstration of the perivenous distribution of MS plaques was further confirmed in 2008 using ultra-high-field MRI 29,30 . Follow-up imaging studies confirmed this finding in relapsing-remitting MS (RRMS), secondary progressive MS (SPMS) and primary progressive MS (PPMS) 31,32 . This perivenous distribution in different MS subtypes is illustrated in FIG.…”

Section: The Central Vein In Ms Discussionmentioning

confidence: 65%

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The central vein sign and its clinical evaluation for the diagnosis of multiple sclerosis: a consensus statement from the North American Imaging in Multiple Sclerosis Cooperative

et al. 2016

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At present, the diagnosis of multiple sclerosis (MS) relies heavily on the use of MRI, which can demonstrate disease dissemination in space and time [1][2][3][4] . The current 2010 McDonald criteria have enabled earlier diagnosis 5,6 and initiation of disease-modifying treatment, with substantial benefits for disease outcome 7,8 , but they still have imperfect sensitivity and specificity 9,10 . The limited accuracy of the criteria results in challenging cases and misdiagnosis, which are prevalent problems in MS 11,12 . Therefore, more-accurate and pathologically specific MRI criteria are still needed to exclude other disorders that can mimic MS 13,14 .The MRI-detectable central vein inside white matter lesions has recently been proposed as a biomarker of inflammatory demyelination and, thus, may aid the diagnosis of MS 15 . The 'central vein sign' (CVS) has been investigated in various neurological conditions by several groups, and evidence has accumulated that the CVS may have the ability to accurately differentiate MS from its mimics [15][16][17][18][19][20][21] . As a consequence, recent guidelines from the Magnetic Resonance Imaging in MS (MAGNIMS) group 1,4 and the Consortium of MS Centers (CMSC) task force 22 have acknowledged the potential of the CVS and its dedicated MRI acquisitions for the differential diagnosis of MS, while calling for further research before considering a possible modification of the diagnostic criteria. However, the lack of standardization for the definition and imaging of the CVS, as well as a dearth of large-scale prospective studies evaluating the CVS for MS diagnosis, are currently preventing the clinical validation of this potential biomarker 1,23 .This Consensus Statement aims to provide recommendations for the definition, standardization and clinical evaluation of the CVS in the diagnosis of MS. These statements are based on a thorough review of the existing literature on the CVS and the consensus opinion of the members of the North American Imaging in Multiple Sclerosis (NAIMS) Cooperative. E X P E RT C O N S E N S U S D O C U M E N T on behalf of the NAIMS CooperativeAbstract | Over the past few years, MRI has become an indispensable tool for diagnosing multiple sclerosis (MS). However, the current MRI criteria for MS diagnosis have imperfect sensitivity and specificity. The central vein sign (CVS) has recently been proposed as a novel MRI biomarker to improve the accuracy and speed of MS diagnosis. Evidence indicates that the presence of the CVS in individual lesions can accurately differentiate MS from other diseases that mimic this condition. However, the predictive value of the CVS for the development of clinical MS in patients with suspected demyelinating disease is still unknown. Moreover, the lack of standardization for the definition and imaging of the CVS currently limits its clinical implementation and validation. On the basis of a thorough review of the existing literature on the CVS and the consensus opinion of the members of the North American Imaging in Mult...

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Section: The Central Vein In Ms Discussionsupporting

confidence: 70%

Section: The Central Vein In Ms Discussionmentioning

confidence: 65%

The central vein sign and its clinical evaluation for the diagnosis of multiple sclerosis: a consensus statement from the North American Imaging in Multiple Sclerosis Cooperative

et al. 2016

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“…Lesion morphology (iron deposition, the presence of the central vein), lesion count, and the proportion of cortical-to-total lesion counts were similar in PPMS and RRMS groups. 27 In PPMS, more diffuse abnormalities in the brain and spinal cord along with smaller caudate volume were apparent compared with RRMS. 28 In PPMS, clinicoradiologic correlation was weak for cerebral T1LL/ T2LL but was stronger between spinal cord symptoms and spinal cord MR imaging parameters.…”

Section: Discussionmentioning

confidence: 93%

Thalamic Iron Differentiates Primary-Progressive and Relapsing-Remitting Multiple Sclerosis

Burgetová¹,

Dušek

Vaněčková³

et al. 2017

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Potential differences between primary progressive and relapsing remitting multiple sclerosis are the subject of ongoing controversial discussions. The aim of this work was to determine whether and how primary-progressive and relapsingremitting multiple sclerosis subtypes differ regarding conventional MR imaging parameters, cerebral iron deposits, and their association with clinical status.

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“…There is ongoing debate as to whether or not primary progressive (PP) and secondary progressive (SP) multiple sclerosis (MS) are essentially the same disease, barring the preceding relapsing-remitting (RR) phase: the age at onset and rate of progression are similar 1 and lesion morphology in relapse-onset and PPMS are identical, 2 but differences have been observed in both MRI and histopathological studies. 3,4 Post-mortem studies have recently revealed meningeal inflammation in all types of MS, [5][6][7] although the most structured form -lymphoid follicle-like aggregates -have only been observed in SPMS, not in PPMS.…”

Section: Introductionmentioning

confidence: 99%

Periventricular magnetisation transfer ratio abnormalities in multiple sclerosis improve after alemtuzumab

et al. 2019

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BackgroundIn relapse-onset multiple sclerosis (MS), tissue abnormality -as assessed with magnetisation transfer ratio (MTR) imaging -is greater in the outer cortical and inner periventricular layers. The cause of this remains unknown but meningeal inflammation has been implicated, particularly lymphoid follicles, which are seen in secondary progressive (SP) but not primary progressive (PP) MS. Cortical and periventricular MTR gradients might therefore differ in PPMS and SPMS if these follicles are responsible. ObjectiveWe assessed cortical and periventricular MTR gradients in PPMS; and compared gradients between people with PPMS and SPMS. MethodsUsing an optimised processing pipeline, periventricular normal-appearing white matter and cortical grey-matter MTR gradients were compared between 51 healthy controls and 63 people with progressive MS (28 PPMS, 35 SPMS). ResultsThe periventricular gradient was significantly shallower in healthy controls (0.122 percentage units (pu)/band) compared to PPMS (0.952 pu/band, p<0.0001) and SPMS (1.360 pu/band, p<0.0001). The cortical gradient was also significantly shallower in healthy controls (-2.860 pu/band) compared to PPMS (-3.214 pu/band, p=0.038) and SPMS (-3.328 pu/band, p=0.016)). ConclusionAbnormal periventricular and cortical MTR gradients occur in both PPMS and SPMS suggesting comparable underlying pathological processes.

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Identical lesion morphology in primary progressive and relapsing–remitting MS –an ultrahigh field MRI study

Cited by 41 publications

References 15 publications

The central vein sign and its clinical evaluation for the diagnosis of multiple sclerosis: a consensus statement from the North American Imaging in Multiple Sclerosis Cooperative

The central vein sign and its clinical evaluation for the diagnosis of multiple sclerosis: a consensus statement from the North American Imaging in Multiple Sclerosis Cooperative

Thalamic Iron Differentiates Primary-Progressive and Relapsing-Remitting Multiple Sclerosis

Periventricular magnetisation transfer ratio abnormalities in multiple sclerosis improve after alemtuzumab

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