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MRI characteristics in Relapsing-Remitting versus Secondary-
Progressive MS
Till Sprenger Department of Neurology and Division of Neuroradiology
University Hospital Basel, Switzerland
MRI features of different phenotypes
Filippi et al. Neurology 1999;52:588-94
Primary versus secondary progressive MS
Thompson et al. Ann Neurol 1991;29:53-62
Patients matched for age, sex, duration of disease and disability
Gadolinium enhancing lesions
Filippi et al. AJNR 1997;18:1549-1556
RRMS: Mean Age: 29; Median EDSS: 1.5 SPMS: Mean Age: 41; Median EDSS: 6.0
Enhancing lesions in early secondary progressive MS
N=60 Patients studied for 4 months with monthly scans Average disease duration: 12 years Total number of Gad+ lesions: 362
Tubridy et al. Brain 1998;121:225–231
Evolution of Gad+ lesions into black holes
-48 MS patients (35 RRMS, 8 SPMS) -789 enhancing lesions SPMS patients had an odds ratio of 4.2 of developing a black hole over 6 months
Minnebo et al. 2005;65:56-61
Brain volumes in different MS phenotypes
Tedeschi et al. Neurology 2005;65:280–285
N=597 MS patients
Upper cervical cord area (UCCA)
Lukas et al. Radiology 2013;269:542-552
N=440
Fisher et al. Ann Neurol 2008;64:255-65
Atrophy in Multiple Sclerosis
Whole brain atrophy in MS
De Stefano et al. Neurology 2010;74(23):1868-76
Spatial patterns of brain atrophy in different MS phenotypes
SPMS
Pagani et al. AJNR 2005;26:341–346
RRMS
n=20
n=19
Ceccarelli et al. Neuroimage 2008
Spatial patterns of brain atrophy in different MS phenotypes
Brain areas with volume decrease in SPMS versus RRMS
N=26 RRMS N=27 SPMS
Differences between progressive and relapsing MS
Antel et al. Acta Neuropathol 2012;123:627-638