1,721,166 research outputs found
Multiple sclerosis and epilepsy: much more than a coincidence
No full textMultiple sclerosis (MS) is a chronic autoimmune demyelinating disease of the central nervous system. Although inflammatory lesions of the white matter are the hallmark of the disease, several neuropathological and imaging studies have clearly confirmed that the grey matter is not spared by the disease. The most recent data suggest that a chronic meningeal inflammation leads to a subpial demyelination resulting in a surface-in gradient of neuronal loss. This article is protected by copyright. All rights reserved
Magnetic resonance evidence of cortical onset of multiple sclerosis
No full textAbstract
BACKGROUND:
Despite clinical symptoms and signs of central nervous system dysfunction, conventional magnetic resonance imaging (MRI) of the brain and spinal cord may appear normal in multiple sclerosis (MS) at clinical onset.
OBJECTIVE:
To demonstrate cortical pathology, namely the presence of cortical lesions (CLs) in patients with symptoms/signs suggestive of MS but having normal appearing white matter (WM) on MRI.
METHODS:
CLs were disclosed by double inversion recovery (DIR) MRI sequence. The final diagnosis of MS was achieved by the demonstration of the dissemination in space and time of WM lesions, and the absence of a better explanation of symptoms/signs, according to the established international diagnostic criteria.
RESULTS:
We describe four patients with MS, in which CLs were observed by DIR months/years before the MRI evidence of inflammatory lesions in the WM.
INTERPRETATION:
We suggest that, at least in some patients with MS, the pathological process underlying MS starts in the cortex. DIR sequence should be included in the MRI examination of suspected patients with MS with normal conventional MRI sequences at clinical onset. CLs should be evaluated for their inclusion in the MRI diagnostic criteria for MS
Therapeutic strategies for relapsing-remitting multiple sclerosis: a special focus on reduction of grey matter damage as measured by brain atrophy.
No full textIn the past two decades, several pathological and radiological findings convincingly demonstrated that damage of the cortical and deep grey matter is a key issue in multiple sclerosis with a significant impact on physical and cognitive disability. Moreover, it has become increasingly evident that the effect of available therapies on the inflammatory white matter damage is not a guarantee of a meaningful effect on the neurodegenerative process mainly affecting the grey matter. Despite the efficacy of all approved disease-modifying drugs should be measured considering such a relevant aspect of the disease, data from clinical trials are few, scattered and heterogeneous. The aim of this review is to summarize the evidence so far acquired on the effect of reducing grey matter damage produced by current and emerging disease-modifying therapies for multiple sclerosis
Cortical Gray Matter MR Imaging in Multiple Sclerosis
No full textSeveral neuropathologic and imaging studies have consistently confirmed that multiple sclerosis affects both white (WM) and gray matter (GM) and that GM damage plays a key role in disability progression. However, differently from WM damage, the less inflammatory cell infiltration, the absence of significant blood-brain barrier damage, the low myelin density in upper cortical layers, as well as technical constraints, make the GM damage almost undetectable by means of conventional MR imaging
Imaging and depression in multiple sclerosis: a historical perspective
No full textPatients affected with multiple sclerosis suffer from depression more frequently than the general population. Beyond psychosocial, genetic and immune-inflammatory factors, also the brain damage which is peculiar of multiple sclerosis has been claimed to have a role in the aetiology of depression in those patients. The study of this interesting relation has been implemented with both conventional and advanced magnetic resonance imaging techniques. The aim of this review is to provide a historical perspective on the link between multiple sclerosis-related depression and structural and functional brain damage
Switching therapy from natalizumab to fingolimod in relapsing-remitting multiple sclerosis: clinical and magnetic resonance imaging findings.
No full textFrequency and severity of COVID-19 in multiple sclerosis: A short single-site report from northern Italy
No full textNeurologists are interested in understanding whether patients with multiple sclerosis (pwMS) undergoing immunomodulatory/immunosuppressive therapy are more susceptible to developing COVID-19 or have worse outcomes. Currently, there are no conclusive data in this regard. We report the prevalence and severity of COVID-19 (confirmed and possible) in pwMS followed at the Veneto Regional MS Center in Verona (Italy), an area most stricken by COVID-19. In our sample size, the prevalence of COVID-19 seems to be much higher than that officially reported at the regional level on the general population, but it also characterized by a favourable course
Crebrospinal fluid examination in the differential diagnosis of inflammato ry myelopathies
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