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Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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Characterizing contrast-enhancing and re-enhancing lesions in multiple sclerosis.

Z Campbell1, D Sahm, K Donohue

  • 1Neuroimmunology Branch (NIB), NIH, Bethesda, MD, USA.

Neurology
|April 28, 2012
PubMed
Summary
This summary is machine-generated.

Nearly 20% of contrast-enhancing lesions (CELs) in multiple sclerosis (MS) are re-enhancing chronic lesions. These re-CELs indicate larger inflammatory areas, distinct from new CELs, in MS patients.

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Area of Science:

  • Radiology
  • Neuroimaging
  • Neurology

Background:

  • Contrast-enhancing lesions (CELs) in T1-weighted postcontrast MRI signify blood-brain barrier breakdown in multiple sclerosis (MS).
  • The significance of re-enhancement in chronic CELs as an indicator of distinct pathology is not well understood.

Purpose of the Study:

  • To determine the incidence of re-enhancing lesions (re-CELs) originating from chronic MS plaques.
  • To compare new CELs (n-CELs) and re-CELs regarding size, magnetization transfer ratio (MTR), and likelihood of forming acute black holes (aBHs).
  • To explore associations between re-CELs and indicators of advanced MS disease.

Main Methods:

  • Retrospective analysis of 264 monthly MRI scans from 88 MS patients over three months.
  • CELs were classified as new (n-CELs) if absent on baseline T2W MRI, or re-enhancing (re-CELs) if present on baseline T2W MRI.

Main Results:

  • A total of 311 n-CELs (82.7%) and 65 re-CELs (17.3%) were identified.
  • Patients with both lesion types showed a higher overall CEL count.
  • Re-CELs were significantly larger and exhibited lower MTR compared to n-CELs, suggesting distinct inflammatory characteristics.

Conclusions:

  • Approximately 20% of CELs in MS represent re-enhancement of chronic lesions.
  • Re-CELs are associated with larger inflammatory areas but not necessarily with larger edema volumes.
  • These findings suggest re-CELs may represent a different pathological process than new CELs in MS.