[Cavitary lesions in multiple sclerosis: multicenter study on twenty patients]

Area of Science:

• Neuroimaging
• Neurology
• White Matter Diseases

Context:

• Cavitary white matter changes are typically associated with leukodystrophies, such as vanishing white matter disease.
• Large cavitary lesions are atypical findings in multiple sclerosis (MS).

Purpose:

• To investigate the characteristics of multiple sclerosis patients presenting with large cavitary brain lesions.
• To differentiate these MS cases from other white matter diseases.

Summary:

• This study analyzed 20 MS patients with large cavitary lesions, noting a predominance of women, later disease onset (mean 37.6 years), and longer duration (mean 10 years).
• Patients often exhibited primary-progressive MS (9/14), high Expanded Disability Status Scale (EDSS) scores (mean 5.5), and severe cognitive dysfunction (mean Mini Mental State score 20/30).
• MRI revealed lesions primarily in the corpus callosum and supratentorial white matter, with posterior predominance, and negative genetic testing for vanishing white matter disease in most cases.

Impact:

• Identifies a specific subgroup of multiple sclerosis patients with unique clinical and radiological features.
• Highlights the importance of considering MS in patients with atypical cavitary white matter lesions.
• Suggests potential for refined diagnostic criteria and targeted therapeutic strategies for this MS subgroup.