Development of Cortical Lesion Volumes on Double Inversion Recovery MRI in Patients With Relapse-Onset Multiple Sclerosis
Background and Objective: In multiple sclerosis (MS) patients, Double Inversion Recovery (DIR) magnetic resonance imaging (MRI) can be used to detect cortical lesions (CL). While the quantity and distribution of CLs seems to be associated with patients' disease course, literature lacks frequent...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-02-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2019.00133/full |
| _version_ | 1818905589985574912 |
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| author | Tobias D. Faizy Gabriel Broocks Christian Thaler Geraldine Rauch Pimrapat Gebert Klarissa H. Stürner Klarissa H. Stürner Klarissa H. Stürner Fabian Flottmann Hannes Leischner Helge C. Kniep Jan-Patrick Stellmann Jan-Patrick Stellmann Christoph Heesen Christoph Heesen Jens Fiehler Susanne Gellißen Uta Hanning |
| author_facet | Tobias D. Faizy Gabriel Broocks Christian Thaler Geraldine Rauch Pimrapat Gebert Klarissa H. Stürner Klarissa H. Stürner Klarissa H. Stürner Fabian Flottmann Hannes Leischner Helge C. Kniep Jan-Patrick Stellmann Jan-Patrick Stellmann Christoph Heesen Christoph Heesen Jens Fiehler Susanne Gellißen Uta Hanning |
| author_sort | Tobias D. Faizy |
| collection | DOAJ |
| description | Background and Objective: In multiple sclerosis (MS) patients, Double Inversion Recovery (DIR) magnetic resonance imaging (MRI) can be used to detect cortical lesions (CL). While the quantity and distribution of CLs seems to be associated with patients' disease course, literature lacks frequent assessments of CL volumes (CL-V) in this context. We investigated the reliability of DIR for the longitudinal assessment of CL-V development with frequent follow-up MRIs and examined the course of CL-V progressions in relation to white-matter lesions (WML), contrast enhancing lesions (CEL) and clinical parameters in patients with Relapsing-Remitting Multiple Sclerosis (RRMS).Methods: In this post-hoc analysis, image- and clinical data of a subset of 24 subjects that were part of a phase IIa clinical trial on the “Safety, Tolerability and Mechanisms of Action of Boswellic Acids in Multiple Sclerosis (SABA)” (ClinicalTrials.gov, NCT01450124) were included. The study was divided in three phases (screening, treatment, study-end). All patients received 12 MRI follow-up-examinations (including DIR) during a 16-months period. CL-Vs were assessed for each patient on each follow-up MRI separately by two experienced neuroradiologists. Results of neurological screening tests, as well as other MRI parameters (WML number and volume and CELs) were included from the SABA investigation data.Results: Inter-rater agreement regarding CL-V assessment over time was good-to-excellent (κ = 0.89). Mean intraobserver variability was 1.1%. In all patients, a total number of 218 CLs was found. Total CL-Vs of all patients increased during the 4 months of baseline screening followed by a continuous and significant decrease from month 5 until study-end (p < 0.001, Kendall'W = 0.413). A positive association between WML volumes and CL-Vs was observed during baseline screening. Decreased CL-V were associated with lower EDSS and also with improvements of SDMT- and SCRIPPS scores.Conclusion: DIR MRI seems to be a reliable tool for the frequent assessment of CL-Vs. Overall CL-Vs decreased during the follow-up period and were associated with improvements of cognitive and disability status scores. Our results suggest the presence of short-term CL-V dynamics in RRMS patients and we presume that the laborious evaluation of lesion volumes may be worthwhile for future investigations.Clinical Trial Numbers:www.ClinicalTrials.gov, “The SABA trial”; number: NCT01450124 |
| first_indexed | 2024-12-19T21:25:45Z |
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| id | doaj.art-8783e506a49c4653be5a556dd7404210 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-19T21:25:45Z |
| publishDate | 2019-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-8783e506a49c4653be5a556dd74042102022-12-21T20:05:08ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-02-011010.3389/fneur.2019.00133447030Development of Cortical Lesion Volumes on Double Inversion Recovery MRI in Patients With Relapse-Onset Multiple SclerosisTobias D. Faizy0Gabriel Broocks1Christian Thaler2Geraldine Rauch3Pimrapat Gebert4Klarissa H. Stürner5Klarissa H. Stürner6Klarissa H. Stürner7Fabian Flottmann8Hannes Leischner9Helge C. Kniep10Jan-Patrick Stellmann11Jan-Patrick Stellmann12Christoph Heesen13Christoph Heesen14Jens Fiehler15Susanne Gellißen16Uta Hanning17Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyInstitute of Medical Biometry and Epidemiology, Charité Berlin-University Medical Center, Berlin, GermanyInstitute of Medical Biometry and Epidemiology, Charité Berlin-University Medical Center, Berlin, GermanyDepartment of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyInstitute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurology, Christian-Albrechts University of Kiel, Kiel, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyInstitute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyInstitute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyBackground and Objective: In multiple sclerosis (MS) patients, Double Inversion Recovery (DIR) magnetic resonance imaging (MRI) can be used to detect cortical lesions (CL). While the quantity and distribution of CLs seems to be associated with patients' disease course, literature lacks frequent assessments of CL volumes (CL-V) in this context. We investigated the reliability of DIR for the longitudinal assessment of CL-V development with frequent follow-up MRIs and examined the course of CL-V progressions in relation to white-matter lesions (WML), contrast enhancing lesions (CEL) and clinical parameters in patients with Relapsing-Remitting Multiple Sclerosis (RRMS).Methods: In this post-hoc analysis, image- and clinical data of a subset of 24 subjects that were part of a phase IIa clinical trial on the “Safety, Tolerability and Mechanisms of Action of Boswellic Acids in Multiple Sclerosis (SABA)” (ClinicalTrials.gov, NCT01450124) were included. The study was divided in three phases (screening, treatment, study-end). All patients received 12 MRI follow-up-examinations (including DIR) during a 16-months period. CL-Vs were assessed for each patient on each follow-up MRI separately by two experienced neuroradiologists. Results of neurological screening tests, as well as other MRI parameters (WML number and volume and CELs) were included from the SABA investigation data.Results: Inter-rater agreement regarding CL-V assessment over time was good-to-excellent (κ = 0.89). Mean intraobserver variability was 1.1%. In all patients, a total number of 218 CLs was found. Total CL-Vs of all patients increased during the 4 months of baseline screening followed by a continuous and significant decrease from month 5 until study-end (p < 0.001, Kendall'W = 0.413). A positive association between WML volumes and CL-Vs was observed during baseline screening. Decreased CL-V were associated with lower EDSS and also with improvements of SDMT- and SCRIPPS scores.Conclusion: DIR MRI seems to be a reliable tool for the frequent assessment of CL-Vs. Overall CL-Vs decreased during the follow-up period and were associated with improvements of cognitive and disability status scores. Our results suggest the presence of short-term CL-V dynamics in RRMS patients and we presume that the laborious evaluation of lesion volumes may be worthwhile for future investigations.Clinical Trial Numbers:www.ClinicalTrials.gov, “The SABA trial”; number: NCT01450124https://www.frontiersin.org/article/10.3389/fneur.2019.00133/fullmultiple sclerosiscerebral cortexinflammationmagnetic resonance imagingcortical lesion volumedouble inversion recovery |
| spellingShingle | Tobias D. Faizy Gabriel Broocks Christian Thaler Geraldine Rauch Pimrapat Gebert Klarissa H. Stürner Klarissa H. Stürner Klarissa H. Stürner Fabian Flottmann Hannes Leischner Helge C. Kniep Jan-Patrick Stellmann Jan-Patrick Stellmann Christoph Heesen Christoph Heesen Jens Fiehler Susanne Gellißen Uta Hanning Development of Cortical Lesion Volumes on Double Inversion Recovery MRI in Patients With Relapse-Onset Multiple Sclerosis Frontiers in Neurology multiple sclerosis cerebral cortex inflammation magnetic resonance imaging cortical lesion volume double inversion recovery |
| title | Development of Cortical Lesion Volumes on Double Inversion Recovery MRI in Patients With Relapse-Onset Multiple Sclerosis |
| title_full | Development of Cortical Lesion Volumes on Double Inversion Recovery MRI in Patients With Relapse-Onset Multiple Sclerosis |
| title_fullStr | Development of Cortical Lesion Volumes on Double Inversion Recovery MRI in Patients With Relapse-Onset Multiple Sclerosis |
| title_full_unstemmed | Development of Cortical Lesion Volumes on Double Inversion Recovery MRI in Patients With Relapse-Onset Multiple Sclerosis |
| title_short | Development of Cortical Lesion Volumes on Double Inversion Recovery MRI in Patients With Relapse-Onset Multiple Sclerosis |
| title_sort | development of cortical lesion volumes on double inversion recovery mri in patients with relapse onset multiple sclerosis |
| topic | multiple sclerosis cerebral cortex inflammation magnetic resonance imaging cortical lesion volume double inversion recovery |
| url | https://www.frontiersin.org/article/10.3389/fneur.2019.00133/full |
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