Mri and trials of neurodegeneration in multiple sclerosis by M. Filippi, M. Rovaris, G. Comi

By M. Filippi, M. Rovaris, G. Comi

In a number of sclerosis (MS), traditional magnetic resonance imaging (cMRI) has proved to be a necessary software to extend diagnostic self belief and for tracking the efficacy of experimental remedy. despite the fact that, cMRI has restricted specificity and accuracy of cMRI to the main disabling facets of the MS pathology, identified to happen in and out of doors macroscopic lesions. smooth quantitative MR ideas have the aptitude to beat the restrictions of cMRI, and their software is altering dramatically our realizing of ways MS explanations irreversible incapacity. intimately, there's an expanding physique of MR proof that MS is not just a white topic disorder and doesn't in basic terms reason focal lesions, in addition to that neurodegeneration is a vital point of the ailment (since the earliest scientific phases), that is merely partly with regards to inflammatory adjustments. there's additionally expanding belief that sleek MR methodologies may be extra largely hired in scientific trials to derive cutting edge information.

Written via world-renowned scientists, the amount presents a state of the art at the most up-to-date MRI strategies on the topic of MS, and it'll bi and fundamental device for all these operating during this field.

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R. DANDAMUDI, A. ARORA, J. STANKIEWICZ, R. BAKSHI Introduction Magnetic resonance imaging (MRI) has become important in the early diagnosis and monitoring of various neurologic disorders including multiple sclerosis (MS). MRI has emerged as a key supportive therapeutic outcome measure in MS-related clinical trials. The limitations of conventional MRI surrogates have driven researchers to develop better biomarkers, including those capturing destructive aspects of the disease. In this chapter, we discuss the most recent data highlighting the role of hypointense lesions on T1-weighted images (black holes; BH) and gray matter (GM) damage in the MRI assessment of MS.

Neurology 60:44-51 94. Jones CK, Riddehough A, Li DKB et al (2001) MRI cerebral atrophy in relapsingremitting MS: results from the PRISMS trial. Neurology 56(Suppl 3):A379 95. Gasperini C, Paolillo A, Giugni E et al (2002) MRI brain volume changes in relapsing-remitting multiple sclerosis patients treated with interferon beta-1a. Mult Scler 8:119-123 96. Molyneux PD, Kappos L, Polman C et al (2000) The effect of interferon beta-1b treatment on MRI measures of cerebral atrophy in secondary progressive multiple sclerosis.

Conclusions The mechanisms involved in atrophy are complex. They partly reflect axonal loss, whether it be through a secondary process such as anterograde or retrograde degeneration, primary neural pathology, or a combination of both. The process is almost certainly multifactorial, and is likely to reflect clinical variability in MS. Both brain and spinal cord measures of atrophy have proved to be clinically relevant, and there is a suggestion that measures of tissue loss in the brain and cord may be complementary, given that regional atrophy may have different clinical consequences.

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