A Preliminary Study Comparing the Sensitivity of Serial Monthly Enhanced MRI After Standard and Triple Dose Gadolinium-DTPA for Monitoring Disease Activity in Primary Progressive Multiple Sclerosis

1998 ◽  
Vol 8 (2) ◽  
pp. 88-93 ◽  
Author(s):  
M. Filippi ◽  
M. Rovaris ◽  
C. Gasperini ◽  
R. Capra ◽  
S. Bastianello ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Activity ◽  
Progressive Multiple Sclerosis ◽  
Primary Progressive Multiple Sclerosis ◽  
Gadolinium Dtpa ◽  
Primary Progressive ◽  
Enhanced Mri ◽  
Preliminary Study ◽  
Triple Dose

Lesion enhancement diminishes with time in primary progressive multiple sclerosis

2010 ◽  
Vol 16 (3) ◽  
pp. 317-324 ◽  
Author(s):  
Z. Khaleeli ◽  
O. Ciccarelli ◽  
K. Mizskiel ◽  
D. Altmann ◽  
DH Miller ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Progressive Multiple Sclerosis ◽  
Primary Progressive Multiple Sclerosis ◽  
Linear Regression Models ◽  
Mixed Effect ◽  
Gadolinium Dtpa ◽  
Primary Progressive ◽  
Inflammatory Phase ◽  
Brain And Spinal Cord

Fewer gadolinium-enhancing lesions are seen in established primary progressive multiple sclerosis (PPMS) compared with other subtypes. Previously, we found unexpectedly high enhancement levels in early PPMS (42%), suggesting an early inflammatory phase. The objective of this study was to investigate whether this level of enhancement was maintained, and whether it influenced clinical progression, over 5 years. Forty-five patients with PPMS, within 5 years of onset, were scored on the Expanded Disability Status Scale (EDSS), Multiple Sclerosis Functional Composite (MSFC) and its subtests (including the timed walk test [TWT]) 6-monthly for 3 years, and at 5 years. T1-weighted brain and spinal cord images after triple dose gadolinium—DTPA, and T2-weighted brain sequences were also acquired. A mixed effect logistic model evaluated change in the percentage of patients with enhancing lesions. Ordinal logistic and multiple linear regression models identified predictors of progression, adjusted for T2 lesion load. The percentage of patients with enhancing lesions in the brain and spinal cord declined over 5 years ( p = 0.03). Among patients with enhancement, more enhancing lesions at baseline predicted greater decline in mobility on the TWT over 5 years ( p = 0.02). In conclusion, a proportion of patients with PPMS may undergo an early inflammatory phase, which has some impact on subsequent mobility.

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