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Pàgina inicial > Articles > Articles publicats > Gadolinium-enhanced brain lesions in multiple sclerosis relapse Lesiones cerebrales captantes de gadolinio en el brote de los pacientes con esclerosis múltiple |
Data: | 2022 |
Resum: | Objective: To study the clinico-radiological paradox in multiple sclerosis (MS) relapse by analyzing the number and location of gadolinium-enhanced (Gd+) lesions on brain MRI before methylprednisolone (MP) treatment. Methods: We analyzed brain MRI from 90 relapsed MS patients in two Phase IV multicenter double-blind randomized clinical trials that showed the noninferiority of different routes and doses of MP administration. A 1. 5- or 3-T brain MRI was performed at baseline before MP treatment and within 15 days of symptom onset. The number and location of Gd+ lesions were analyzed. Associations were studied using univariate analysis. Results: Sixty-two percent of patients had at least 1 Gd+ brain lesion; the median number was 1 (interquartile range 0-4), and 41% of patients had 2 or more lesions. The most frequent location of Gd+ lesions was subcortical (41. 4%). Gd+ brain lesions were found in 71. 4% of patients with brainstem-cerebellum symptoms, 57. 1% with spinal cord symptoms and 55. 5% with optic neuritis (ON). Thirty percent of patients with brain symptoms did not have Gd+ lesions, and only 43. 6% of patients had symptomatic Gd+ lesions. The univariate analysis showed a negative correlation between age and the number of Gd+ lesions (p = 0. 002). Conclusion: Most patients with relapse showed several Gd+ lesions on brain MRI, even when the clinical manifestation was outside of the brain. Our findings illustrate the clinico-radiological paradox in MS relapse and support the value of brain MRI in this scenario. |
Ajuts: | Ministerio de Sanidad EC07/90278 Ministerio de Sanidad EC11/132 Instituto de Salud Carlos III CM19/00042 |
Drets: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades. |
Llengua: | Castellà |
Document: | Article ; recerca ; Versió publicada |
Matèria: | Multiple Sclerosis ; Relapse ; MRI ; Gadolinium enhancement |
Publicat a: | Neurología, Vol. 37 Núm. 7 (septiembre 2022) , p. 557-563, ISSN 1578-1968 |
7 p, 631.6 KB |