The role of pontine lesion location in differentiating multiple sclerosis from vascular risk factor-related small vessel disease
Geraldes, Ruth (Nuffield Department of Clinical Neurosciences)
Juryńczyk, Maciej (Nuffield Department of Clinical Neurosciences)
dos Passos, Giordani Rodrigues (Nuffield Department of Clinical Neurosciences)
Pichler, Alexander (Medical University of Graz. Department of Neurology)
Chung, Karen (University College London Institute of Neurology)
Hagens, Marloes (Vrije Universiteit Amsterdam. Department of Neurology)
Ruggieri, Serena (San Camillo Forlanini Hospital)
Auger, Cristina (Hospital Universitari Vall d'Hebron)
Sastre-Garriga, Jaume (Hospital Universitari Vall d'Hebron)
Enzinger, Christian (Medical University of Graz. Department of Neurology)
Chard, Declan (University College London. Institute of Neurology)
Barkhof, Frederik (Vrije Universiteit Amsterdam. Department of Radiology and Nuclear Medicine)
Gasperini, Claudio (San Camillo Forlanini Hospital)
Rovira, Alex (Hospital Universitari Vall d'Hebron)
DeLuca, Gabriele (Nuffield Department of Clinical Neurosciences)
Palace, Jacqueline (Nuffield Department of Clinical Neurosciences)
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	Differentiating multiple sclerosis (MS) from vascular risk factor (VRF)-small vessel disease (SVD) can be challenging. In order to determine whether or not pontine lesion location is a useful discriminator of MS and VRF-SVD, we classified pontine lesions on brain magnetic resonance imaging (MRI) as central or peripheral in 93 MS cases without VRF, 108 MS patients with VRF and 43 non-MS cases with VRF. MS without VRF were more likely to have peripheral pons lesions (31. 2%, 29/93) than non-MS with VRF (0%, 0/43) (Exp(B) = 29. 8; 95% confidence interval (CI) = (1. 98, 448. 3); p = 0. 014) but there were no significant differences regarding central pons lesions between MS without VRF (5. 4%, 5/93) and non-MS with VRF patients (16. 3%, 7/43) (Exp(B) = 0. 89; 95% CI = (0. 2, 3. 94); p = 0. 87). The presence of peripheral pons lesions discriminated between MS and VRF-SVD with 100% (95% CI = (91. 8, 100)) specificity. The proportion of peripheral pons lesions in MS with VRF (30. 5%, 33/108) was similar to that seen in MS without VRF (31. 2%, 29/93, p = 0. 99). Central lesions occurred in similar frequency in MS with VRF (8. 3%, 9/108) and non-MS with VRF (16. 3%, 7/43, p = 0. 15). Peripheral pons lesion location is a good discriminator of MS from vascular lesions.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Estudi clínic ; recerca ; Versió publicada
Subject:	Multiple sclerosis ; Cerebral small vessel disease ; Imaging ; Differential diagnosis
Published in:	Multiple sclerosis, Vol. 27 Núm. 6 (2021) , p. 968-972, ISSN 1477-0970

DOI: 10.1177/1352458520943777
PMID: 32757905

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