| Brain damage as detected by magnetization transfer imaging is less pronounced in benign than in early relapsing multiple sclerosis. | |
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MedLine Citation:
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PMID: 16815879 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The trend to start disease-modifying therapy early in the course of multiple sclerosis makes it important to establish whether the benign form is a real entity. In previous studies, measures of magnetization transfer (MT) ratio (MTr) have been shown to provide good estimates of the amount of tissue damage occurring in multiple sclerosis brains. Thus, with the hypothesis that if benign multiple sclerosis patients were really benign, sensitive measures of subtle tissue damage would be less pronounced in these patients than in very early relapsing-remitting (RR) multiple sclerosis patients. We carried out conventional MRI and MT imaging in 50 patients with benign multiple sclerosis [defined as having Kurtzke Expanded Disability Status Score (EDSS) <3 and disease duration >15 years] and in 50 early RR patients selected to have similar disability (EDSS <3) and short disease duration (<3 years). Data were compared with those of 32 demographically-matched normal controls. We used a fully automated procedure to measure lesional-MTr, perilesional-MTr, normal-appearing white matter (NAWM) MTr and cortical-MTr. We found that, after correction for common effects of age, lesional-MTr and perilesional-MTr of benign patients were significantly (P < 0.0001) lower than WM of normal controls, but significantly (P < 0.0001) higher than corresponding tissues of RR patients. In NAWM and cortex, MTr values of benign patients were similar to those of normal controls (P > 0.5) and significantly higher than those of the RR patients (P < 0.0001 and P < 0.01, respectively). Similar differences in MTr measures between benign and RR patients were found when patient groups were selected to have no disability (EDSS < or = 2) and, for benign multiple sclerosis, very long disease duration (>20 years) or when both groups were matched for high lesion load (T2-weighted lesion volume >10 cm3). We conclude that lesional and non-lesional MTr values can be significantly less pronounced in benign multiple sclerosis than in a cohort of RR patients at their earliest disease stages, suggesting that brain tissue damage is milder in benign multiple sclerosis than in early RR disease. This can be due to an extraordinary beneficial response to demyelination of benign patients and may represent the evidence that benign multiple sclerosis truly exists and might be differentiated from other forms of this illness. |
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Authors:
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Nicola De Stefano; Marco Battaglini; M L Stromillo; Valentina Zipoli; M L Bartolozzi; Leonello Guidi; Gianfranco Siracusa; Emilio Portaccio; Antonio Giorgio; Sandro Sorbi; Antonio Federico; Maria Pia Amato |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2006-06-30 |
Journal Detail:
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Title: Brain : a journal of neurology Volume: 129 ISSN: 1460-2156 ISO Abbreviation: Brain Publication Date: 2006 Aug |
Date Detail:
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Created Date: 2006-07-27 Completed Date: 2006-09-29 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0372537 Medline TA: Brain Country: England |
Other Details:
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Languages: eng Pagination: 2008-16 Citation Subset: AIM; IM |
Affiliation:
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Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences, University of Siena, Italy. destefano@unisi.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors Aged Brain / pathology* Diagnosis, Differential Female Humans Image Processing, Computer-Assisted / methods Magnetic Resonance Imaging Male Middle Aged Multiple Sclerosis / pathology* Multiple Sclerosis, Relapsing-Remitting / pathology |
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