Magnetic resonance imaging in HTLV-I associated myelopathy

Melo, Aílton; Moura, Luciana Monteiro; Rios, Solana; Machado, Marcos; Costa, Gersonita

doi:10.1590/s0004-282x1993000300006

Cited by 22 publications

(11 citation statements)

References 10 publications

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“…3). Increased (3)(4)(5)(6)(7)(8)(15)(16)(17). In particular, thoracic cord atrophy without signal intensity changes on MRI is accepted to be characteristic of HAM/TSP, but its incidence was varied, ranging from 20% to 74% (6)(7)(8).…”

Section: F I G U R E 1 T H O R a C I C C O R D Mr I Ma G E S I N T mentioning

confidence: 99%

Incidence and Clinical Significances of Human T-cell Lymphotropic Virus Type I-Associated Myelopathy with T2 Hyperintensity on Spinal Magnetic Resonance Images

et al. 2008

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Section: F I G U R E 1 T H O R a C I C C O R D Mr I Ma G E S I N T mentioning

confidence: 99%

Incidence and Clinical Significances of Human T-cell Lymphotropic Virus Type I-Associated Myelopathy with T2 Hyperintensity on Spinal Magnetic Resonance Images

et al. 2008

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“…Whereas strength usually is preserved, deep tendon reflexes tend to be brisk in the upper extremities, and sensory findings are usually minimal. Magnetic resonance imaging (MRI) has shown that thoracic cord atrophy with increased signals in the periventricular and subcortical white matter on T2‐weighted images are the most commonly observed findings 26–30. However, these are considered to be relatively nonspecific, and opinions differ on whether they can effectively be differentiated from changes due to aging, collagen vascular disease, or small lacunar infarcts.…”

Section: Neurological Diseasementioning

confidence: 99%

Human T‐lymphotropic virus type II and neurological disease

Araújo

Hall

2004

Annals of Neurology

154

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Human T-lymphotropic virus type I (HTLV-I) and type II (HTLV-II) are closely related retroviruses with similar biological properties and common modes of transmission. HTLV-I infection is endemic in well-defined geographic regions, and it is estimated that some 20 million individuals are infected worldwide. Although most infected individuals are asymptomatic carriers, some 2 to 5% will develop a chronic encephalomyelopathy, HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). In contrast with HTLV-I, the role of HTLV-II in the development of neurological disorders is much less clear. HTLV-II is endemic in many native Amerindian groups and epidemic in injecting drug users (IDUs) worldwide. To evaluate the role of HTLV-II in neurological disease, we have critically reviewed all reported cases of HTLV-II-associated disorders. This has confirmed that although rare infection is associated with a disorder clinically similar or identical to HAM/TSP. However, most reports that have attributed infection to a range of other neurological disorders are difficult to evaluate in that in many cases either the association appears to be fortuitous or the presentations were confounded by a background of concomitant human immunodeficiency virus-1 infection and/or active IDU. In view of the many HTLV-II-infected individuals in urban areas of North America and Europe, neurologists should be aware of the potential clinical consequences of this infection.

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“…3,4 Lesions seen in the mid to lower thoracolumbar spinal cord are the most severe and account for the main clinical symptoms, with predominant involvement of the lateral columns and cord atrophy. [4][5][6][7] However, measurement of spinal cord atrophy is still suboptimal in HAM/TSP.…”

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confidence: 99%

In vivo imaging of spinal cord atrophy in neuroinflammatory diseases

Liu

Nair

Vuolo

et al. 2014

Annals of Neurology

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Objective Spinal cord atrophy is prominent in chronic progressive neurologic diseases such as Human-T-cell lymphotropic virus type-1 (HTLV-1) associated myelopathy/tropical spastic paraparesis (HAM/TSP) and multiple sclerosis (MS). Here we compared the spinal cord cross-sectional area (SCCSA) in HAM/TSP and MS to that of healthy volunteers (HV). Methods SCCSA and clinical disability scores were measured in 18 HAM/TSP, 4 asymptomatic carriers (AC) of HTLV-1, 18 MS, and 10 HV from a 3T MRI. SCCSA measured in patients and AC were compared to that of HV and correlated with disability scores. Results The entire spinal cord in HAM/TSP was thin compared to HV, whereas only the cervical cord in MS was thinner than HV (p<0·0001). In HAM/TSP, SCCSA extensively correlated with Ambulation Index, whereas only the cervical cord correlated with disease duration (p<0·05). In MS, the SCCSA extensively correlated with Scripps Neurologic Rating Score and the Expanded Disability Status Scale (p<0·05). One of the four ACs showed atrophy in a pattern similar to HAM/TSP. Interpretation These results are in accordance with the findings that whereas over half of all lesions in an MS cord are seen in the upper cervical cord, most of the pathology in HAM/TSP is seen in the thoracolumbar cord, which in turn may be responsible for more extensive cord atrophy seen in HAM/TSP. Imaging marker such as SCCSA might serve as a surrogate endpoint in clinical trials, especially to assess the neuroprotective impact of various therapies.

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Magnetic resonance imaging in HTLV-I associated myelopathy

Cited by 22 publications

References 10 publications

Incidence and Clinical Significances of Human T-cell Lymphotropic Virus Type I-Associated Myelopathy with T2 Hyperintensity on Spinal Magnetic Resonance Images

Incidence and Clinical Significances of Human T-cell Lymphotropic Virus Type I-Associated Myelopathy with T2 Hyperintensity on Spinal Magnetic Resonance Images

Human T‐lymphotropic virus type II and neurological disease

In vivo imaging of spinal cord atrophy in neuroinflammatory diseases

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