Neuropsychological impairment in multiple sclerosis patients: the role of                 (juxta)cortical lesion on FLAIR

Lazeron, R.H.C.; Langdon, Dawn; Filippi, Massimo; Waesberghe, J.H.T.M. van; Stevenson, VL; Boringa, J.B.S.; Origgi, Daniela; Thompson, Alan J.; Falautano, Monica; Polman, CH; Barkhof, Frederik

doi:10.1177/135245850000600410

Cited by 85 publications

(33 citation statements)

References 36 publications

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“…The refinement of MRI techniques has coincided with a substantial literature showing correlations between MRI indices and cognitive dysfunction, such as regional and total lesion load detected by T1 and T2 weighted MRI, 105 juxtacortical lesions, 106 and regional and generalized atrophy. 107 The latter is perhaps the most important cerebral predictor of cognitive dysfunction.…”

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confidence: 97%

Fatigue and depression in multiple sclerosis: pharmacological and non-pharmacological interventions

Brenner

Piehl

2016

Acta Neurol Scand

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Multiple sclerosis (MS) is a neuroinflammatory condition with a prominent progressive neurodegenerative facet that typically affects young-or middle-aged adults. Although physical disabilities have been in the foreground by being easier to assess, there is an increasing interest in mental disabilities and psychiatric co-morbidities, which have a disproportionally high impact on important outcome measures such as quality of life and occupational disability. In particular, cognitive impairment, depression and mental fatigue, which mutually interact with each other, seem to be of importance in this context. In recent decades, major efforts have been invested in developing more effective disease modulatory treatments. This has resulted in novel therapeutic options and awareness of the importance of early intervention. In comparison, good quality and adequately powered studies on symptomatic treatments of fatigue and psychiatric co-morbidities in MS are rare, and awareness of treatment options is much lower. We here review the existing evidence base for symptomatic treatment of fatigue and depression in MS patients. With regard to fatigue, off-label prescription of alertness improving drugs is common, in spite of all but absent evidence of efficacy. In contrast, a number of smaller studies suggest that physical exercise and fatigue management courses may have some clinical benefit. Very few studies have addressed the efficacy of antidepressants and non-pharmaceutical interventions specifically in MS patients. Therefore, treatment guidelines largely rely on data from non-MS populations. In the future, there is a strong motive to direct additional resources to the study of these important aspects of MS. K E Y W O R D Scognitive symptoms, depression, fatigue, multiple sclerosis, treatment

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confidence: 97%

Fatigue and depression in multiple sclerosis: pharmacological and non-pharmacological interventions

Brenner

Piehl

2016

Acta Neurol Scand

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“…There is evidence that fluidattenuated inversion recovery (FLAIR) sequence improves detection of lesions within the cortex, and that enhancement with gadolinium may accentuate their visibility. [7][8][9] Unfortunately, these sequences do not clearly differentiate between purely intracortical and mixed gray-white matter lesions. In a recent study, 10 even when high-resolution MR imaging of postmortem specimens were examined, considerably fewer cortical lesions were identified than when the tissues were examined histologically.…”

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confidence: 99%

Improved Identification of Intracortical Lesions in Multiple Sclerosis with Phase-Sensitive Inversion Recovery in Combination with Fast Double Inversion Recovery MR Imaging

Nelson¹,

Poonawalla²,

Hou³

et al. 2007

American Journal of Neuroradiology

186

178

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BACKGROUND AND PURPOSE:Accurate detection and classification of purely intracortical lesions in multiple sclerosis (MS) are important in understanding their role in disease progression and impact on the clinical manifestations of the disease. However, detection of these lesions with conventional MR imaging remains a challenge. Although double inversion recovery (DIR) has been shown to improve the sensitivity of the detection of cortical lesions, this sequence has low signal-to-noise ratio (SNR), poor delineation of lesion borders, and is prone to image artifacts. We demonstrate that intracortical lesions can be identified and classified with greater confidence by the combination of DIR with phase-sensitive inversion recovery (PSIR) images.

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“…Cortical lesions (CLs) are thought to contribute significantly to disease severity in multiple sclerosis (MS), [1][2][3][4][5] and dominate disease pathology in the progressive phase. 6 Therefore, reliable in vivo detection of CLs is crucial.…”

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confidence: 99%

Postmortem verification of MS cortical lesion detection with 3D DIR

Seewann¹,

et al. 2012

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Objective: To assess the sensitivity and specificity of 3D double inversion recovery (DIR) MRI for detecting multiple sclerosis (MS) cortical lesions (CLs) using a direct postmortem MRI to histopathology comparison.Methods: Single-slab 3D DIR and 3D fluid-attenuated inversion recovery (FLAIR) images of 56 matched fresh brain samples from 14 patients with chronic MS were acquired at 1.5 T. The images of both sequences were prospectively scored for CLs in consensus by 3 experienced raters who were blinded to histopathology and clinical data. Next, CLs were identified histopathologically and were scored again on 3D DIR and 3D FLAIR (retrospective scoring). CLs were classified as intracortical or mixed gray matter (GM)-white matter lesions. Deep GM lesions were also scored. False-positive scores were noted and, from this, specificity was calculated. Results:We found a sensitivity for 3D DIR to detect MS CLs of 18%, which is 1.6-fold higher than 3D FLAIR (improves to 37% with retrospective scoring; 2.0-fold higher than 3D FLAIR). We detected mixed GM-white matter lesions with a sensitivity of 83% using 3D DIR (65% sensitivity for 3D FLAIR), which improved to 96% upon retrospective scoring (91% for 3D FLAIR). For purely intracortical lesions, 3D DIR detected more than 2-fold more than 3D FLAIR (improved to Ͼ3-fold upon retrospective scoring). The specificity of 3D DIR to MS CLs was found to be 90%. Conclusions:In this postmortem verification study, we have shown that 3D DIR is highly pathologically specific, and more sensitive to CLs than 3D FLAIR in MS. Neurology ® 2012;78:302-308 GLOSSARY BSA ϭ bovine serum albumin; CL ϭ cortical lesion; DIR ϭ double inversion recovery; FLAIR ϭ fluid-attenuated inversion recovery; GM ϭ gray matter; MS ϭ multiple sclerosis; NEX ϭ number of excitations; PBS ϭ phosphate-buffered saline; PLP ϭ proteolipid protein; TE ϭ echo time; TI ϭ inversion time; TR ϭ repetition time; WM ϭ white matter.

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Neuropsychological impairment in multiple sclerosis patients: the role of (juxta)cortical lesion on FLAIR

Cited by 85 publications

References 36 publications

Fatigue and depression in multiple sclerosis: pharmacological and non-pharmacological interventions

Fatigue and depression in multiple sclerosis: pharmacological and non-pharmacological interventions

Improved Identification of Intracortical Lesions in Multiple Sclerosis with Phase-Sensitive Inversion Recovery in Combination with Fast Double Inversion Recovery MR Imaging

Postmortem verification of MS cortical lesion detection with 3D DIR

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