Corpus Callosum Index: A practical method for long-term follow-up in multiple sclerosis
Autor(a) principal: | |
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Data de Publicação: | 2007 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Arquivos de neuro-psiquiatria (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2007000600001 |
Resumo: | Rather than acute inflammation, long-standing multiple sclerosis (MS) course is hallmarked by relentless axonal loss and brain atrophy, both with subtle clinical expression and scarcely visible on conventional MRI studies. Brain atrophy imaging has sophisticated methodological requirements, not always practical and accessible to most centers. Corpus callosum (CC) is a major inter-hemispheric white matter bundle, grossly affected by long term MS and easily assessed by MRI. To determine whether a practical imaging method can reliably follow presumed axonal loss in patients with progressive MS, we designed a 5-year prospective open label study, enrolling 128 consecutive patients (75 relapsing-remitting (RR) and 53 secondary-progressive (SP)), on regular immunomodulatory therapy compared to control group, formed by 23 patients with MRI considered normal. On a conventional best mid-saggital T1W, CC index (CCI) was obtained by measuring anterior, medium and posterior segments of CC, normalized to its greatest anteroposterior diameter using an orthogonal semi-automated linear system. CCI was measured at baseline and at least once yearly. Results were plotted intra-individually; baseline values were used as reference. At baseline, CCI was able to distinguish SP patients from RR and controls, and on follow-up, despite some overlap, demonstrated a progressive reduction from baseline on both RR and SP groups compared to controls. From the third year on, difference between SP and RR patients reached statistical significance, which did not correlated with disability measured by EDSS. So, a corpus callosum index proved practical and feasible to longitudinally demonstrate morphometric callosal changes with potential to be used as a tool for long-term follow-up, mostly in SP patients. |
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Corpus Callosum Index: A practical method for long-term follow-up in multiple sclerosismultiple sclerosisMRIcorpus callosumRather than acute inflammation, long-standing multiple sclerosis (MS) course is hallmarked by relentless axonal loss and brain atrophy, both with subtle clinical expression and scarcely visible on conventional MRI studies. Brain atrophy imaging has sophisticated methodological requirements, not always practical and accessible to most centers. Corpus callosum (CC) is a major inter-hemispheric white matter bundle, grossly affected by long term MS and easily assessed by MRI. To determine whether a practical imaging method can reliably follow presumed axonal loss in patients with progressive MS, we designed a 5-year prospective open label study, enrolling 128 consecutive patients (75 relapsing-remitting (RR) and 53 secondary-progressive (SP)), on regular immunomodulatory therapy compared to control group, formed by 23 patients with MRI considered normal. On a conventional best mid-saggital T1W, CC index (CCI) was obtained by measuring anterior, medium and posterior segments of CC, normalized to its greatest anteroposterior diameter using an orthogonal semi-automated linear system. CCI was measured at baseline and at least once yearly. Results were plotted intra-individually; baseline values were used as reference. At baseline, CCI was able to distinguish SP patients from RR and controls, and on follow-up, despite some overlap, demonstrated a progressive reduction from baseline on both RR and SP groups compared to controls. From the third year on, difference between SP and RR patients reached statistical significance, which did not correlated with disability measured by EDSS. So, a corpus callosum index proved practical and feasible to longitudinally demonstrate morphometric callosal changes with potential to be used as a tool for long-term follow-up, mostly in SP patients.Academia Brasileira de Neurologia - ABNEURO2007-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2007000600001Arquivos de Neuro-Psiquiatria v.65 n.4a 2007reponame:Arquivos de neuro-psiquiatria (Online)instname:Academia Brasileira de Neurologiainstacron:ABNEURO10.1590/S0004-282X2007000600001info:eu-repo/semantics/openAccessFigueira,Fernando Faria AndradeSantos,Valeria Silva dosFigueira,Gustavo Medeiros AndradeSilva,Ângela Correa Marques daeng2007-12-06T00:00:00Zoai:scielo:S0004-282X2007000600001Revistahttp://www.scielo.br/anphttps://old.scielo.br/oai/scielo-oai.php||revista.arquivos@abneuro.org1678-42270004-282Xopendoar:2007-12-06T00:00Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologiafalse |
dc.title.none.fl_str_mv |
Corpus Callosum Index: A practical method for long-term follow-up in multiple sclerosis |
title |
Corpus Callosum Index: A practical method for long-term follow-up in multiple sclerosis |
spellingShingle |
Corpus Callosum Index: A practical method for long-term follow-up in multiple sclerosis Figueira,Fernando Faria Andrade multiple sclerosis MRI corpus callosum |
title_short |
Corpus Callosum Index: A practical method for long-term follow-up in multiple sclerosis |
title_full |
Corpus Callosum Index: A practical method for long-term follow-up in multiple sclerosis |
title_fullStr |
Corpus Callosum Index: A practical method for long-term follow-up in multiple sclerosis |
title_full_unstemmed |
Corpus Callosum Index: A practical method for long-term follow-up in multiple sclerosis |
title_sort |
Corpus Callosum Index: A practical method for long-term follow-up in multiple sclerosis |
author |
Figueira,Fernando Faria Andrade |
author_facet |
Figueira,Fernando Faria Andrade Santos,Valeria Silva dos Figueira,Gustavo Medeiros Andrade Silva,Ângela Correa Marques da |
author_role |
author |
author2 |
Santos,Valeria Silva dos Figueira,Gustavo Medeiros Andrade Silva,Ângela Correa Marques da |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Figueira,Fernando Faria Andrade Santos,Valeria Silva dos Figueira,Gustavo Medeiros Andrade Silva,Ângela Correa Marques da |
dc.subject.por.fl_str_mv |
multiple sclerosis MRI corpus callosum |
topic |
multiple sclerosis MRI corpus callosum |
description |
Rather than acute inflammation, long-standing multiple sclerosis (MS) course is hallmarked by relentless axonal loss and brain atrophy, both with subtle clinical expression and scarcely visible on conventional MRI studies. Brain atrophy imaging has sophisticated methodological requirements, not always practical and accessible to most centers. Corpus callosum (CC) is a major inter-hemispheric white matter bundle, grossly affected by long term MS and easily assessed by MRI. To determine whether a practical imaging method can reliably follow presumed axonal loss in patients with progressive MS, we designed a 5-year prospective open label study, enrolling 128 consecutive patients (75 relapsing-remitting (RR) and 53 secondary-progressive (SP)), on regular immunomodulatory therapy compared to control group, formed by 23 patients with MRI considered normal. On a conventional best mid-saggital T1W, CC index (CCI) was obtained by measuring anterior, medium and posterior segments of CC, normalized to its greatest anteroposterior diameter using an orthogonal semi-automated linear system. CCI was measured at baseline and at least once yearly. Results were plotted intra-individually; baseline values were used as reference. At baseline, CCI was able to distinguish SP patients from RR and controls, and on follow-up, despite some overlap, demonstrated a progressive reduction from baseline on both RR and SP groups compared to controls. From the third year on, difference between SP and RR patients reached statistical significance, which did not correlated with disability measured by EDSS. So, a corpus callosum index proved practical and feasible to longitudinally demonstrate morphometric callosal changes with potential to be used as a tool for long-term follow-up, mostly in SP patients. |
publishDate |
2007 |
dc.date.none.fl_str_mv |
2007-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2007000600001 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2007000600001 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S0004-282X2007000600001 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Academia Brasileira de Neurologia - ABNEURO |
publisher.none.fl_str_mv |
Academia Brasileira de Neurologia - ABNEURO |
dc.source.none.fl_str_mv |
Arquivos de Neuro-Psiquiatria v.65 n.4a 2007 reponame:Arquivos de neuro-psiquiatria (Online) instname:Academia Brasileira de Neurologia instacron:ABNEURO |
instname_str |
Academia Brasileira de Neurologia |
instacron_str |
ABNEURO |
institution |
ABNEURO |
reponame_str |
Arquivos de neuro-psiquiatria (Online) |
collection |
Arquivos de neuro-psiquiatria (Online) |
repository.name.fl_str_mv |
Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologia |
repository.mail.fl_str_mv |
||revista.arquivos@abneuro.org |
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