The clinical-radiological paradox in multiple sclerosis: myth or truth?
| Autor: | Hartmann A; Universidade Federal do Rio de Janeiro, Departamento de Radiologia, Rio de Janeiro RJ, Brazil., Noro F; Universidade Federal do Rio de Janeiro, Departamento de Radiologia, Rio de Janeiro RJ, Brazil., Bahia PRV; Universidade Federal do Rio de Janeiro, Departamento de Radiologia, Rio de Janeiro RJ, Brazil., Fontes-Dantas FL; Universidade Estadual do Rio de Janeiro, Departamento de Farmacologia e Psicobiologia, Rio de Janeiro RJ, Brazil., Andreiuolo RF; Rede Dor, São Luiz, Rio de Janeiro RJ, Brazil., Lopes FCR; Universidade Federal Fluminense, Departamento de Radiologia, Rio de Janeiro RJ, Brazil., Pereira VCSR; Universidade Federal do Rio de Janeiro, Departamento de Neurologia, Rio de Janeiro RJ, Brazil., Coutinho RA; Universidade Federal do Rio de Janeiro, Departamento de Neurologia, Rio de Janeiro RJ, Brazil., Araujo AD; Universidade Federal do Rio de Janeiro, Departamento de Neurologia, Rio de Janeiro RJ, Brazil., Marchiori E; Universidade Federal do Rio de Janeiro, Departamento de Radiologia, Rio de Janeiro RJ, Brazil., Alves-Leon SV; Universidade Federal do Rio de Janeiro, Departamento de Neurologia, Rio de Janeiro RJ, Brazil.; Universidade Federal do Estado do Rio de Janeiro, Laboratório de Neurociências Translacional. Soniza Vieira Alves-Leon, Rio de Janeiro RJ, Brazil. |
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| Jazyk: | angličtina |
| Zdroj: | Arquivos de neuro-psiquiatria [Arq Neuropsiquiatr] 2023 Jan; Vol. 81 (1), pp. 55-61. Date of Electronic Publication: 2023 Mar 14. |
| DOI: | 10.1055/s-0042-1758457 |
| Abstrakt: | 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. Competing Interests: The authors have no conflict of interests to declare. (Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).) |
| Databáze: | MEDLINE |
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