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The clinical-radiological paradox in multiple sclerosis: myth or truth?

Background  Multiple sclerosis (MS) is an inflammatory, degenerative, demyelinating disease that ranges from benign to rapidly progressive forms. A striking characteristic of the disease is the clinical-radiological paradox. Objectives  The present study was conducted to determine whether, in our co...

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Autores principales: Hartmann, Ana, Noro, Fabio, Bahia, Paulo Roberto Valle, Fontes-Dantas, Fabricia Lima, Andreiuolo, Rodrigo Ferrone, Lopes, Fernanda Cristina Rueda, Pereira, Valeria Coelho Santa Rita, Coutinho, Renan Amaral, Araujo, Amanda Dutra de, Marchiori, Edson, Alves-Leon, Soniza Vieira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Revinter Publicações Ltda. 2023
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10014204/
https://www.ncbi.nlm.nih.gov/pubmed/36918008
http://dx.doi.org/10.1055/s-0042-1758457
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author Hartmann, Ana
Noro, Fabio
Bahia, Paulo Roberto Valle
Fontes-Dantas, Fabricia Lima
Andreiuolo, Rodrigo Ferrone
Lopes, Fernanda Cristina Rueda
Pereira, Valeria Coelho Santa Rita
Coutinho, Renan Amaral
Araujo, Amanda Dutra de
Marchiori, Edson
Alves-Leon, Soniza Vieira
author_facet Hartmann, Ana
Noro, Fabio
Bahia, Paulo Roberto Valle
Fontes-Dantas, Fabricia Lima
Andreiuolo, Rodrigo Ferrone
Lopes, Fernanda Cristina Rueda
Pereira, Valeria Coelho Santa Rita
Coutinho, Renan Amaral
Araujo, Amanda Dutra de
Marchiori, Edson
Alves-Leon, Soniza Vieira
author_sort Hartmann, Ana
collection PubMed
description Background  Multiple sclerosis (MS) is an inflammatory, degenerative, demyelinating disease that ranges from benign to rapidly progressive forms. A striking characteristic of the disease is the clinical-radiological paradox. Objectives  The present study was conducted to determine whether, in our cohort, the clinical-radiological paradox exists and whether lesion location is related to clinical disability in patients with MS. Methods  Retrospective data from 95 patients with MS (60 women and 35 men) treated at a single center were examined. One head-and-spine magnetic resonance imaging (MRI) examination from each patient was selected randomly, and two independent observers calculated lesion loads (LLs) on T2/fluid attenuation inversion recovery sequences manually, considering the whole brain and four separate regions (periventricular, juxtacortical, posterior fossa, and spinal cord). The LLs were compared with the degree of disability, measured by the Kurtzke Expanded Disability Status Scale (EDSS), at the time of MRI examination in the whole cohort and in patients with relapsing-remitting (RR), primarily progressive, and secondarily progressive MS. Results  High LLs correlated with high EDSS scores in the whole cohort (r = 0.34; p  < 0.01) and in the RRMS group (r = 0.27; p  = 0.02). The EDSS score correlated with high regional LLs in the posterior fossa (r = 0.31; p  = 0.002) and spinal cord (r = 0.35; p  = 0.001). Conclusions  Our results indicate that the clinical-radiological paradox is a myth and support the logical connection between lesion location and neurological repercussion.
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spelling pubmed-100142042023-03-15 The clinical-radiological paradox in multiple sclerosis: myth or truth? Hartmann, Ana Noro, Fabio Bahia, Paulo Roberto Valle Fontes-Dantas, Fabricia Lima Andreiuolo, Rodrigo Ferrone Lopes, Fernanda Cristina Rueda Pereira, Valeria Coelho Santa Rita Coutinho, Renan Amaral Araujo, Amanda Dutra de Marchiori, Edson Alves-Leon, Soniza Vieira Arq Neuropsiquiatr Background  Multiple sclerosis (MS) is an inflammatory, degenerative, demyelinating disease that ranges from benign to rapidly progressive forms. A striking characteristic of the disease is the clinical-radiological paradox. Objectives  The present study was conducted to determine whether, in our cohort, the clinical-radiological paradox exists and whether lesion location is related to clinical disability in patients with MS. Methods  Retrospective data from 95 patients with MS (60 women and 35 men) treated at a single center were examined. One head-and-spine magnetic resonance imaging (MRI) examination from each patient was selected randomly, and two independent observers calculated lesion loads (LLs) on T2/fluid attenuation inversion recovery sequences manually, considering the whole brain and four separate regions (periventricular, juxtacortical, posterior fossa, and spinal cord). The LLs were compared with the degree of disability, measured by the Kurtzke Expanded Disability Status Scale (EDSS), at the time of MRI examination in the whole cohort and in patients with relapsing-remitting (RR), primarily progressive, and secondarily progressive MS. Results  High LLs correlated with high EDSS scores in the whole cohort (r = 0.34; p  < 0.01) and in the RRMS group (r = 0.27; p  = 0.02). The EDSS score correlated with high regional LLs in the posterior fossa (r = 0.31; p  = 0.002) and spinal cord (r = 0.35; p  = 0.001). Conclusions  Our results indicate that the clinical-radiological paradox is a myth and support the logical connection between lesion location and neurological repercussion. Thieme Revinter Publicações Ltda. 2023-03-14 /pmc/articles/PMC10014204/ /pubmed/36918008 http://dx.doi.org/10.1055/s-0042-1758457 Text en Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit ( https://creativecommons.org/licenses/by/4.0/ ) https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Hartmann, Ana
Noro, Fabio
Bahia, Paulo Roberto Valle
Fontes-Dantas, Fabricia Lima
Andreiuolo, Rodrigo Ferrone
Lopes, Fernanda Cristina Rueda
Pereira, Valeria Coelho Santa Rita
Coutinho, Renan Amaral
Araujo, Amanda Dutra de
Marchiori, Edson
Alves-Leon, Soniza Vieira
The clinical-radiological paradox in multiple sclerosis: myth or truth?
title The clinical-radiological paradox in multiple sclerosis: myth or truth?
title_full The clinical-radiological paradox in multiple sclerosis: myth or truth?
title_fullStr The clinical-radiological paradox in multiple sclerosis: myth or truth?
title_full_unstemmed The clinical-radiological paradox in multiple sclerosis: myth or truth?
title_short The clinical-radiological paradox in multiple sclerosis: myth or truth?
title_sort clinical-radiological paradox in multiple sclerosis: myth or truth?
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10014204/
https://www.ncbi.nlm.nih.gov/pubmed/36918008
http://dx.doi.org/10.1055/s-0042-1758457
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