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Are Periventricular Lesions Specific for Multiple Sclerosis?

Gianna Casini1, Mary Yurashevich1, Rohini Vanga1

  • 1Department of Neurology, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.

Journal of Neurology & Neurophysiology
|January 9, 2015
PubMed
Abstract

Insights

Periventricular lesions (PVL) on MRI are not specific for multiple sclerosis (MS). While increased in relapsing-remitting MS (RRMS) compared to migraine, PVL in other brain areas and in stroke patients showed no significant differences, questioning their diagnostic value.

Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Periventricular lesions (PVL) on MRI are key in multiple sclerosis (MS) diagnosis.
  • However, PVL also appear in stroke and migraine, complicating MS differentiation.
  • Migraine is common in MS patients, necessitating careful lesion interpretation.

Purpose of the Study:

  • To assess the specificity of periventricular lesions (PVL) for multiple sclerosis (MS).
  • To compare PVL presence in MS (clinically isolated syndrome/relapsing-remitting MS) versus stroke and migraine patients.

Main Methods:

  • Brain MRI scans (FLAIR) were analyzed for PVL number, location, and volume.
  • Patients with clinically isolated syndrome (CIS), relapsing-remitting MS (RRMS), migraine, and ischemic stroke were included.
  • Comparative analysis of PVL characteristics across these neurological conditions was performed.

Main Results:

  • Significantly higher PVL number and volume near the lateral ventricles' body and posterior horn in RRMS compared to migraine.
  • No significant differences in total PVL number/volume between RRMS and ischemic stroke.
  • PVL near anterior/temporal horns showed no significant difference between migraine and CIS/RRMS.

Conclusions:

  • PVL near the lateral ventricles' body and posterior horn may help differentiate RRMS from migraine.
  • PVL in other locations, or overall PVL counts, are not specific for MS when compared to migraine or stroke.
  • The diagnostic specificity of PVL for MS requires further investigation, especially considering comorbid conditions like migraine.
Keywords:
MRIMigraineMultiple sclerosisStroke

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