Insights into the Course of Illness of MS: Clinical and Radiological Aspects
Roberto Bomprezzi,
Andrew Chen,
Christopher Hemond
Issue:
Volume 6, Issue 2, June 2022
Pages:
19-28
Received:
10 March 2022
Accepted:
30 March 2022
Published:
9 April 2022
DOI:
10.11648/j.cnn.20220602.11
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Abstract: Patients with MS manifest a high degree of variability in their disease course and at first glance the disease outcome may seem unpredictable. Here we present a framework for clinicians challenged by the management of MS patients and by highlighting important aspects of the disease to be taken into account, we review the complex relationship between inflammation and neuronal degeneration. Details of illustrative cases are here described with the goal to emphasize the involvement of the spinal cord as a key element leading to progressive phases of the disease and to underscore the utility of recent paraclinical tools including quantified MRI volumetrics. We provide insights that allow understanding the variability of disease courses of MS, assessing the rate by which the disease generates clinical and radiological burdens for individual patients, and how currently available treatments have a predictable impact on outcomes. In line with latest views on the therapeutic approach for MS, instituting an immune therapy capable of arresting the inflammatory process before the cascade of degenerative phenomena takes place is portrayed as a strategy to prevent progressive stages of the disease, increasing the chance to induce a state of permanent remission when the treatment could be discontinued.
Abstract: Patients with MS manifest a high degree of variability in their disease course and at first glance the disease outcome may seem unpredictable. Here we present a framework for clinicians challenged by the management of MS patients and by highlighting important aspects of the disease to be taken into account, we review the complex relationship betwee...
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Changes in Cortical Thickness Are Associated with Cognitive Impairments in Patients with White Matter Lesions
Na Wei,
Yufei Wei,
Yuexiu Li,
Decai Tian,
Hongyan Chen,
Yumei Zhang
Issue:
Volume 6, Issue 2, June 2022
Pages:
29-36
Received:
8 June 2022
Accepted:
27 June 2022
Published:
5 July 2022
DOI:
10.11648/j.cnn.20220602.12
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Views:
Abstract: White matter lesions (WMLs) are closely related with cognitive impairment and dementia. It has been hypothesized that cognitive impairment is related to cortical atrophy and cortical thickness network measurements in certain brain regions. We aimed to investigate the characteristics of cortical thickness in patients with WMLs and the relationship that these characteristics have with cognitive function. In this study, 76 WML patients and 37 healthy controls (HC) were enrolled and underwent a T1-weighted 3-D MRI scan using a 3.0-Tesla scanner. According to cognitive assessment results, the WML patients were divided into two subgroups, namely the WMLs with non-dementia vascular cognitive impairment (WML-VCIND) group and the WMLs with vascular dementia (WML-VaD) group. Cortical surface thickness was estimated using FreeSurfer software. The correlation between cognitive function and cortical thickness in WML patients was analyzed. We found that MoCA scores and executive function were significantly decreased in WML-VCIND and WML-VaD patients compared to the HC group (P < 0.0001). Significantly reduced cortical thickness in the left precentral, caudal middle frontal, rostral middle frontal, superior frontal, middle temporal, transverse temporal, insula, bilateral pars opercularis, and superior temporal regions was found in the WML-VaD group compared to the HC group (P < 0.05). The reduced cortical thickness of the above gyrus was positively correlated with executive function in WML patients. These cross-sectional results suggest that decreased cortex thickness in certain gyri in WML patients might lead to cognitive decline. The correlation between cortical thickness changes and cognitive function holds promise for understanding the underlying causes of cognitive impairment in WMLs.
Abstract: White matter lesions (WMLs) are closely related with cognitive impairment and dementia. It has been hypothesized that cognitive impairment is related to cortical atrophy and cortical thickness network measurements in certain brain regions. We aimed to investigate the characteristics of cortical thickness in patients with WMLs and the relationship t...
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