Neuroimaging clinics of North America
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Increased iron deposition in cerebral deep gray matter has been considered a global marker for neurodegeneration in multiple sclerosis (MS); it scales with disease duration and severity. Iron accumulation in white matter and MS lesions might be more directly related to disease activity and has been discussed as a contributor to the inflammatory and neurodegenerative cascade. ⋯ We discuss findings from MR iron mapping proposed. Because of the confounding magnetic properties of myelin, iron mapping in white matter remains an unresolved issue.
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Neuroimaging Clin. N. Am. · May 2017
ReviewMultiple Sclerosis: Epidemiologic, Clinical, and Therapeutic Aspects.
Multiple sclerosis (MS) is a chronic autoimmune and degenerative disease of the central nervous system that affects young people. MS develops in genetically susceptible individuals exposed to different unknown triggering factors. Different phenotypes are described. ⋯ An increasing number of disease-modifying treatments has emerged. Although encouraging, the number of drugs challenges the neurologist because each treatment has its own risk-benefit profile. Patients should be involved in the decision-making process to ensure good treatment and safety monitoring adherence.
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Multiple sclerosis is a multifactorial disease with heterogeneous pathogenetic mechanisms, which deserve to be studied to evaluate new possible targets for treatments and improve patient management. MR spectroscopy and PET allow assessing in vivo the molecular and metabolic mechanisms underlying the pathogenesis of multiple sclerosis. This article focuses on the relationship between these imaging techniques and the biologic and chemical pathways leading to multiple sclerosis pathology and its clinical features. Future directions of research are also presented.
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Neuroimaging Clin. N. Am. · May 2017
ReviewMicrostructural MR Imaging Techniques in Multiple Sclerosis.
Due to its sensitivity in the detection of focal white matter (WM) lesions, MR imaging has become a paraclinical tool central to diagnosing multiple sclerosis (MS) and monitoring its evolution. Despite this, the correlation between patients' clinical status and conventional MR imaging measures is weak to moderate. Quantitative MR imaging-based techniques, such as magnetization transfer and diffusion tensor imaging, have a higher specificity toward the heterogeneous pathologic substrates of MS than MR imaging. This article discusses the main insights derived from the application of such MR imaging-based techniques to define MS pathophysiology and to quantify the progressive accumulation of structural damage in the central nervous system.
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Neuroimaging Clin. N. Am. · May 2017
ReviewRadiologically Isolated Syndrome: MR Imaging Features Suggestive of Multiple Sclerosis Prior to First Symptom Onset.
Remarkable advances in the understanding of the biology of multiple sclerosis have been achieved through the use of conventional and novel MR imaging techniques of the central nervous system. With improvements in access by patients and utilization of MR imaging technology in health care, an increasing number of unanticipated structural anomalies are being appreciated. In certain instances, white matter abnormalities within the brain and spinal cord are discovered in subjects with no prior history of neurologic symptoms supportive of inflammatory demyelinating events.