Isolated U-fiber involvement in MS

Abstract

We studied the frequency and location of isolated U-fiber involvement in MS and correlated these findings exploratively with physical disability and neuropsychological impairment. Fifty-three MS patients were examined. Three-millimeter-thick, fast spin-echo T2-weighted MR images and spin-echo postgadolinium T1-weighted images were obtained. Computer software that which had been validated previously for quantitation of MS lesions was used to detect lesions on the T2-weighted images. The Expanded Disability Status Scale (EDSS), Ambulation Index (AI), and a battery of neurocognitive tests were performed on each patient. Forty-two arcuate hyperintensities along the U-fiber were detected by the software in 28 patients (53%). Twenty-seven lesions (64.3%) were seen in the frontal lobe, eight (19.0%) in the temporal lobe, three (7.1%) in the parietal lobe, three (7.1%) in the occipital lobe, and one (2.4%) in both frontal and parietal lobes. Four lesions (9.5%) showed gadolinium enhancement. Seventeen lesions (40%) were hypointense on the T1-weighted images. Scores of three of the 11 neuropsychological tests reflecting performance in executive control and memory were significantly different at least at the p = 0.05 level between the eight patients with multiple, isolated U-fiber lesions and the 45 patients without any or with only a single U-fiber lesion. No significant difference was noted for EDSS or AI. Isolated U-fiber involvement is an underappreciated MR finding in MS. Our preliminary hypothesis is that U-fiber lesions may contribute to neuropsychological impairment, although our observation requires confirmation.

Imaging Differences between Neuromyelitis Optica Spectrum Disorders and Multiple Sclerosis: A Multi-Institutional Study in Japan

“…All patients with NMO/NMOSD were defined according to the NMO/ NMOSD criteria published in 2006 and 2007, respectively, and fulfilled the 2015 International Panel for NMO Diagnosis criteria. 14 For simplification, we referred to all patients with NMO/ NMOSD as NMOSD. 15 21 isolated U-fiber/juxtacortical lesions (lesions extending along the subcortical U-fibers), 16 dirty white matter lesions (subtle, abnormal areas that showed patchy and slightly higher signal intensity than the surrounding normal-appearing white matter but lower signal intensity than the plaques), 22 tumefactive MS lesions (lesions of Ͼ2 cm, mass effect, edema, and/or ring enhancement), 23 and cloudlike enhancement (multiple patchy enhancement with a blurred margin in adjacent regions, in comparison with isolated enhancing lesions) 24 according to the previously reported criteria.…”

White matter and lesion T1 relaxation times increase in parallel and correlate with disability in multiple sclerosis

“…Defining pathology in grey matter is important to avoid underestimating the true disease burden in an individual. Grey matter changes potentially can be significant [4,17] and may contribute towards both physical and cognitive impairments [23].…”

Um sistema nervoso conceitual para o diagnóstico neuropsicológico

“…Um exemplo de desconexão funcional é a lesão do fascículo arqueado esquerdo no hemisfério esquerdo, a qual foi implicada na origem dos sintomas depressivos (Pujol et al, 1997). A ocorrência mais rara de síndromes neuropsicológicas focais, tais como afasia, é explicada pela lesão das fibras de conexão córtico-cortical de curta distância, ou fibras arqueadas (Miki et al, 1998; veja a lesão b na Figura 6, representada pelo quadrado).…”