Multiple sclerosis lesion formation and early evolution revisited: A weekly high-resolution magnetic resonance imaging study.

Autor:	Guttmann CR; Center for Neurological Imaging, Brigham and Women's Hospital, USA., Rousset M; Service de Radiologie, Centre Hospitalier Lyon-Sud, France., Roch JA; Service de Radiologie, Centre Hospitalier Lyon-Sud, France/CREATIS, Université de Lyon, France., Hannoun S; CREATIS, Université de Lyon, France., Durand-Dubief F; CREATIS, Université de Lyon, France/Service de Neurologie, Hospices Civils de Lyon, France., Belaroussi B; BioClinica SAS, France., Cavallari M; Center for Neurological Imaging, Brigham and Women's Hospital, USA., Rabilloud M; Service de Biostatistique, Hospices Civils de Lyon, France., Sappey-Marinier D; CREATIS, Université de Lyon, France/Département IRM, CERMEP-Imagerie du Vivant, France., Vukusic S; Service de Neurologie, Hospices Civils de Lyon, France., Cotton F; Service de Radiologie, Centre Hospitalier Lyon-Sud, France/CREATIS, Université de Lyon, France francois.cotton@chu-lyon.fr.
Jazyk:	angličtina
Zdroj:	Multiple sclerosis (Houndmills, Basingstoke, England) [Mult Scler] 2016 May; Vol. 22 (6), pp. 761-9. Date of Electronic Publication: 2015 Sep 11.
DOI:	10.1177/1352458515600247
Abstrakt:	Background: Several magnetic resonance imaging (MRI) studies investigated the evolution of multiple sclerosis (MS) lesions to understand the pathophysiological mechanisms leading to blood-brain barrier breakdown and lesion formation. Only a few assessed the early natural history of MS lesions using short-interval longitudinal MRI. Objective: The purpose of this study was to characterize MS lesion occurrence and early evolution on high-resolution MRI acquired at weekly intervals. Methods: Active lesions were characterized on 3D fluid attenuation inversion recovery (FLAIR) and gadolinium-enhanced 3D T1-weighted MRI performed weekly (seven weeks) on five untreated patients with relapsing-remitting MS (RRMS). Results: Active lesions (n=212) were detected in all patients. All showed contrast-enhancement on at least one time-point. Most new lesions (83.5%) were visible on FLAIR and post-contrast T1-weighted images at first detection; 11.2% showed activity on FLAIR images, one or more weeks before the appearance of contrast-enhancement; 12.5% enhanced before being apparent on FLAIR. Conclusion: Blood brain barrier disruption is a constant step in the natural history of active MS lesions, but does not always constitute the initial event. These findings are consistent with the existence of a subpopulation of lesions with an 'inside-out' genesis, where neurodegenerative processes might precede microglial activation, and a subsequent adaptive immune response. (© The Author(s), 2015.)
Databáze:	MEDLINE
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