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Updated: Aug 16, 2026
Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
Published on: July 4, 2007
Delayed MR imaging changes in acute disseminated encephalomyelitis
J Honkaniemi1, P Dastidar, V Kähärä
1Departments of Neurology and Rehabilitation, Tampere University Hospital and Medical School, University of Tampere, Tampere, Finland.
Background And Purpose:
White matter lesions on MR images obtained from patients with acute disseminated encephalomyelitis (ADEM) have been reported to appear shortly after symptom onset, and their resolution has been claimed to parallel recovery. To elucidate the temporal evolution of these lesions and to associate the changes on MR images to the patients' clinical condition, we performed serial MR imaging on patients with ADEM.
Methods:
Several consecutive T2-weighted and fluid-attenuated inversion recovery scans were obtained from four previously healthy adult patients with ADEM within the first days after the onset of symptoms and again during the recovery period. MR imaging was done first on a weekly to biweekly basis and later at 1- to 2-month intervals for up to 8 months.
Results:
MR scans of three of these patients did not show any specific abnormalities until several weeks after the onset of the disease. As the lesions later appeared, their number increased during the recovery period.
Conclusion:
MR imaging performed during the first days after the onset of the disease may not reveal any pathologic findings. The appearance of the ADEM-associated MR imaging changes may be associated with recovery rather than decline. It remains to be studied whether the new MR imaging techniques reveal the lesions associated with ADEM faster than the conventional T2-weighted imaging.
Insights
Serial MRI in acute disseminated encephalomyelitis (ADEM) reveals white matter lesions may appear during recovery, not at symptom onset. This challenges previous understandings of ADEM
Area of Science:
- Neurology
- Radiology
- Neuroimmunology
Background:
- White matter lesions in acute disseminated encephalomyelitis (ADEM) are typically observed on MRI shortly after symptom onset.
- Previous claims suggested lesion resolution parallels patient recovery.
Purpose of the Study:
- To investigate the temporal evolution of white matter lesions in ADEM using serial MRI.
- To correlate MRI findings with the clinical status of ADEM patients.
Main Methods:
- Serial T2-weighted and FLAIR MRI scans were performed on four adult ADEM patients.
- Imaging occurred within days of symptom onset and during recovery, with follow-up for up to 8 months.
Main Results:
- Three patients showed no abnormalities on initial MRI scans weeks after symptom onset.
- The number of white matter lesions increased during the recovery phase.
Conclusions:
- Early MRI (first few days) may not detect ADEM-related pathology.
- ADEM-associated MRI changes might coincide with clinical recovery rather than disease progression.
- Further research is needed to determine if advanced MRI techniques can detect lesions earlier.
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