#2
NeuroPsychological Impairment In Multiple Sclerosis Patients: The Role Of JuxtaCortical Lesion On FLAIR
Lazeron RH, Langdon DW, Filippi M, van Waesberghe JH, Stevenson VL, Boringa JB, Origgi D, Thompson AJ, Falautano M, Polman CH, Barkhof F
Mult Scler 2000 Aug;6(4):280-285
MS-MRI center of the Academic Hospital, Vrije Universiteit, Dept of Radiology, Amsterdam, The Netherlands
PMID# 10962549
Abstract
In this study, we evaluated the correlation between NeuroPsychological Impairment (measured with the Brief Repeatable Battery NeuroPsychological Tests).
And JuxtaCortical lesions detected with FLAIR and the relative sensitivity of the FLAIR sequence compared to Spin-Echo MRI sequences in detecting JuxtaCortical MS lesions.
A total of 39 patients with Definite MS were evaluated by MRI with a conventional and fast Spin Echo sequence and fast-FLAIR sequence.
And NeuroPsychological tests of the Brief Repeatable Battery NeuroPsychological tests were performed. The Z-score of all subtests were used to calculate a Cognitive Impairment Index.
The results show that a high number of JuxtaCortical lesions is detected with thin slice FLAIR (30% of all lesions seen). This percentage was not superior to Spin-Echo, reflecting the thin slice thickness (3 mm) we used.
The lesions detected with FLAIR were to a certain degree different ones than the lesions detected with the other techniques.
While the number of Non-Cortical lesions correlated with the Expanded Disability Status Scale (r=0.32, P=0.045), the number of JuxtaCortical lesions detected with the FLAIR showed a correlation (r=0.34, P=0.035) with the Cognitive Impairment Index.
Our study underlines the high number of JuxtaCortical lesions in MS and the value of thin slice FLAIR sequence to detect such lesions with MRI.
It also stresses the importance of JuxtaCortical lesions on determining NeuroPsychological Impairment.
Multiple Sclerosis (2000) 6 280 - 285
#3
Johnson KP, Brooks BR, Ford CC, Goodman A, Guarnaccia J, Lisak RP, Myers LW, Panitch HS, Pruitt A, Rose JW, Kachuck N, Wolinsky JS
Mult Scler 2000 Aug;6(4):255-266
Univ of Maryland, Dept of Neurology, Baltimore, Maryland, USA
PMID# 10962546; UI# 20420517
Abstract
In a randomized, placebo-controlled, double-blind study, Glatiramer Acetate (Copaxone(R)) reduced the relapse rate and slowed accumulation of disability for patients with Relapsing/Remitting Multiple Sclerosis.
Of the original 251 patients randomized to receive Glatiramer Acetate or placebo, 208 chose to continue in an open-label study with all patients receiving active drug.
The majority of the original double-blind cohort continues to receive Glatiramer Acetate by daily subcutaneous injection and are evaluated at 6-month intervals and during suspected relapse.
The data reported here are from approximately 6 years of organized evaluation, including the double-blind phase of up to 35 months and the open-label phase of over 36 months. Daily subcutaneous injections of 20 mg Glatiramer Acetate were well tolerated.
The mean annual relapse rate of the patients who received Glatiramer Acetate since randomization and continued into the open-label study was 0.42 (95% confidence interval (CI), CI=0.34 - 0.51). The rate per year has continued to drop and for the sixth year is 0.23.
Of the group who have received Glatiramer Acetate without interruption for 5 or more years, 69.3% were Neurologically unchanged or have improved from baseline by at least one step on the Expanded Disability Status Scale (EDSS).
Patients who left the open-label phase were surveyed by questionnaire. The majority responded, providing information about their current status and reasons for dropping out.
This study demonstrates the sustained efficacy of Glatiramer Acetate in reducing the relapse rate and in slowing the accumulation of disability in patients with Relapsing forms of Multiple Sclerosis.
Multiple Sclerosis (2000) 6 255 - 266
#4
VisuoPerceptual Impairment In Multiple Sclerosis Diagnosed With NeuroPsychological Tasks
Vleugels L, Lafosse C, Nunen A, Nachtergaele S, Ketelaer P, Charlier M, Vandenbussche E
Mult Scler 2000 Aug;6(4):241-254
National Multiple Sclerosis Centre, Dept of Rehabilitation, B-1820 Melsbroek, Belgium
PMID# 10962545
Abstract
A comprehensive set of 31 Binocular NeuroPsychological tasks assessing a series of Spatial and Non-Spatial VisuoPerceptual abilities was used to study VisuoPerceptual Impairment.
In a representative group of 49 MS-clinic patients exhibiting neither diagnosed Ophthalmological afflictions nor major Psychiatric diagnoses.
Among these patients, true frequency rate of VisuoPerceptual Impairment, i.e. of subjects failing four or more tasks, was estimated at 26%.
The pattern of VisuoPerceptual Impairment was non-uniform, non-selective, restricted and idiosyncratic. Only four tasks yielded significant rates of impairment.
They concerned Color Discrimination, the perception of the Muller-Lyer illusion and Object Recognition in two separate conditions.
Each of the four factors identified by factor analysis had an important representative (with factor loading >0.35) among these four tasks. Failures on these tasks correlated poorly.
Together, the four tasks satisfactorily predicted VisuoPerceptual Impairment as defined by the comprehensive set of tasks (sensitivity 86.7%; specificity 81.3%), but with regard to an uncontaminated criterion, their aggregate sensitivity and specificity was only 75 and 56% respectively.
VisuoPerceptual NeuroPsychological task performance related significantly but weakly to Cognitive Status, Physical Disability and to Pyramidal, Cerebellar and BrainStem Neurological Signs.
And did not correlate with other clinical Neurological Signs, disease duration, type of MS, a history of Optic Neuritis, Depression or medication status.
Multiple Sclerosis (2000) 6 241 - 254 |