Intercenter differences in diffusion tensor MRI acquisition.

Purpose: To assess the effect on diffusion tensor (DT) magnetic resonance imaging (MRI) of acquiring data with different scanners.

Materials And Methods: Forty-four healthy controls and 36 multiple sclerosis patients with low disability were studied using eight MR scanners with acquisition protocols that were as close to a standard protocol as possible. Between 7 and 13 subjects were studied in each center.

Detection of viral DNA sequences in the cerebrospinal fluid of patients with multiple sclerosis.

The role of viruses in the pathogenesis of multiple sclerosis (MS) is a subject of heated debate. The presence of six different neurotropic viruses was sought, including JC virus (JCV), varicella zoster virus (VZV), human herpesvirus 6 (HHV-6), and Epstein-Barr virus (EBV), in cerebrospinal fluid (CSF) samples collected from 51 patients with MS and 30 patients with other neurological diseases. Cell-free or cell-associated viral DNA in CSF samples was detected by real-time PCR, and viral loads were determined.

Assessment of white matter tract damage in patients with amyotrophic lateral sclerosis: a diffusion tensor MR imaging tractography study.

Background And Purpose: Most DTI studies in ALS have been limited to the assessment of the CST damage. In this study, we used DTI tractography to investigate whether microstructural abnormalities occur in the major motor and extramotor WM tracts in mildly disabled patients with ALS.

Materials And Methods: Brain conventional MR imaging and DTI were performed in 24 patients with probable or definite ALS and mild disability (ALSFRS score, ≥20) and 20 healthy controls.

Serum DNA motifs predict disease and clinical status in multiple sclerosis.

Using recently available mass sequencing and assembly technologies, we have been able to identify and quantify unique cell-free DNA motifs in the blood of patients with multiple sclerosis (MS). The most common MS clinical syndrome, relapsing-remitting MS (RRMS), is accompanied by a unique fingerprint of both inter- and intragenic cell-free circulating nucleic acids as specific DNA sequences that provide significant clinical sensitivity and specificity. Coding genes that are differentially represented in MS serum encode cytoskeletal proteins, brain-expressed regulators of growth, and receptors involved in nervous system signal transduction.

Cervical cord functional MRI changes in relapse-onset MS patients.

Objective: To investigate whether (1) the tactile-associated cord functional MRI (fMRI) changes vary in the different clinical stages of relapse-onset multiple sclerosis (MS), and (2) the pattern of cord fMRI changes relates to severity of MS clinical disability.

Methods: Cervical cord fMRI was acquired from 49 MS patients (30 relapsing-remitting (RR), 19 secondary progressive (SP)), and 19 controls, during a tactile stimulation of the right hand. Task-related cord mean signal change and occurrence of fMRI activity at each cord quadrant and level were measured.

Atlas-based vs. individual-based deterministic tractography of corpus callosum in multiple sclerosis.

Diffusion tensor (DT) magnetic resonance imaging is able to quantify tissue microstructure properties and to detect pathological changes even in the normal appearing tissues. DT sequence parameters which provide optimal SNR and minimum acquisition time, and an individual-based tractography post-processing allowed corpus callosum tractography even in multiple sclerosis (MS) patients also with no need of a-priori atlas. In this preliminary study, we were able to obtain reliable individual-based tractography in 28/30 MS patients.

HLA-class I markers and multiple sclerosis susceptibility in the Italian population.

Previous studies reported an association with multiple sclerosis (MS) of distinct HLA-class I markers, namely HLA-A*02, HLA-Cw*05 and MOG-142L. In this work, we tested the association with MS of A*02 and Cw*05 in 1273 Italian MS patients and 1075 matched controls, which were previously analyzed for MOG-142, and explored the relationship among these three markers in modulating MS risk. HLA-A*02 conferred a statistically robust MS protection (odds ratio, OR=0.

Costimulatory pathways in multiple sclerosis: distinctive expression of PD-1 and PD-L1 in patients with different patterns of disease.

T lymphocytes costimulatory molecules, including CD80, CD86, CD28, CTLA4, PD-1, PD-L1, and B7-H3, are associated with the preferential production of pro- or anti-inflammatory cytokines. We analyzed the expression of these molecules and myelin basic protein (MBP)-specific IL-10 and IFN-gamma production in patients with multiple sclerosis (MS) with relapsing-remitting acute (AMS, n = 40) or stable (SMS, n = 38). Twenty-two patients successfully undergoing therapy with glatimer acetate (n = 12) or IFNbeta (n = 10) were also analyzed.

Primary progressive multiple sclerosis: tactile-associated functional MR activity in the cervical spinal cord.

Purpose: To assess the extent of tactile-associated cervical spinal cord activation in patients with primary progressive (PP) multiple sclerosis (MS) and to investigate the relationship between spinal cord functional activation and the severity of cervical spinal cord and brain structural damage by using magnetic resonance (MR) images.

Materials And Methods: The study was conducted with institutional review board approval. Written informed consent was obtained from each participant.

Risk of deep venous thrombosis (DVT) in bedridden or wheelchair-bound multiple sclerosis patients: a prospective study.

Background: Multiple sclerosis (MS) often causes progressive loss of mobility, leading to limb paralysis. Venous and lymphatic stasis is a risk condition for venous thromboembolism (VTE). There is, however, no data on the frequency of VTE complicating the progression of MS.

A diffusion tensor MRI study of cervical cord damage in benign and secondary progressive multiple sclerosis patients.

Background: Diffusion tensor (DT) MRI enables quantification of the severity of brain and cervical cord pathology in multiple sclerosis (MS).

Objective: To investigate DT MRI patterns of cervical cord damage in patients with benign MS (BMS) and secondary progressive MS (SPMS), in order to achieve a better understanding of the mechanisms underlying the development of irreversible disability in MS.

Methods: Conventional and DT MRI scans of the cervical cord and brain were acquired from 40 BMS patients, 28 SPMS patients and 18 healthy individuals.

In-vivo evidence for stable neuroaxonal damage in the brain of patients with benign multiple sclerosis.

Objective: The term benign multiple sclerosis (BMS) is referred to patients who have a mild or absent disability several years after disease clinical onset. Axonal damage can be measured in vivo using proton MR spectroscopy ((1)H-MRS). In this study, we quantified the severity of "global" axonal damage in BMS and early relapsing-remitting (RR) MS patients, using whole brain N-acetylaspartate (WBNAA) (1)H-MRS, to better elucidate the structural correlates of a non-disabling disease evolution.

Multiple sclerosis-associated retroviral agent (MSRV)-stimulated cytokine production in patients with relapsing-remitting multiple sclerosis.

Background: Human endogenous retroviruses are suggested to play a pathogenic role in multiple sclerosis (MS); one of such retroviruses, the MS-associated retroviral agent (MSRV) has repeatedly been isolated in MS patients.

Objective And Methods: We analyzed cytokine profiles in MSRV envelope protein (MSRV ENV-SU)-stimulated peripheral blood mononuclear cells of 30 relapsing-remitting MS patients with either acute (AMS) (n = 13) or stable (SMS) (n = 17) disease. Results suggest that MSRV ENV-SU induces the production of inflammatory cytokines, including tumor necrosis factor-alpha (P < 0.

Corpus callosum damage and cognitive dysfunction in benign MS.

Corpus callosum (CC), the largest compact white matter fiber bundle of the human brain involved in interhemispheric transfer, is frequently damaged in the course of multiple sclerosis (MS). Cognitive impairment is one of the factors affecting quality of life of patients with benign MS (BMS). The aim of this study was to investigate the relationship between the cognitive profile of BMS patients and the extent of tissue damage in the CC.

Longitudinal assessment of grey matter contraction in amyotrophic lateral sclerosis: A tensor based morphometry study.

Our objective was to investigate grey matter (GM) contraction in patients with amyotrophic lateral sclerosis (ALS) using tensor based morphometry (TBM). Using a 1.5 Tesla scanner, T1-weighted MRI scans were obtained at baseline and at follow-up (mean interval, 9 months) from 16 ALS and 10 controls.

Solitary splenic metastasis of ovarian carcinoma: report of two cases.

Capsular splenic metastasis from ovarian cancer, which is associated with peritoneal spread, is not uncommon. Conversely, solitary involvement of the splenic parenchymal is unusual, and secondary debulking may improve the prognosis if there is no sign of residual disease. Thus, splenectomy is indicated for this type of isolated splenic metastasis.

A longitudinal diffusion tensor MRI study of the cervical cord and brain in amyotrophic lateral sclerosis patients.

Objective: To define the temporal evolution of intrinsic tissue damage and atrophy in the cervical cord and the brain portion of the corticospinal tracts (CST) from patients with amyotrophic lateral sclerosis (ALS).

Methods: Conventional and diffusion tensor (DT) magnetic resonance imaging (MRI) of the cervical cord and brain were obtained from 17 ALS patients and 20 controls, at baseline and after a mean follow-up of 9 months. The following measurements were assessed: (a) cervical cord cross-sectional area, average mean diffusivity (MD) and average fractional anisotropy (FA); and (b) CST T2-visible hyperintensities, average MD and FA.

Cognitive impairment and structural brain damage in benign multiple sclerosis.

Objective: Although in benign multiple sclerosis (BMS) locomotor disability is absent or only minimal, subclinical cognitive impairment seems to occur in many cases. Diffusion tensor (DT) MRI enables us to quantify the extent of "actual" tissue damage, which goes undetected when using conventional MRI. Against this background, we investigated the extent of structural brain damage underlying cognitive dysfunction in BMS, with the ultimate aim to move a first step toward a more reliable definition of this disease phenotype.

A magnetic resonance imaging voxel-based morphometry study of regional gray matter atrophy in patients with benign multiple sclerosis.

Background: Evidence is accumulating that indicates that a selected assessment of gray matter (GM) damage is able to provide strong paraclinical correlates of multiple sclerosis (MS) severity.

Objective: To investigate the pattern of regional GM atrophy in patients with benign MS (BMS) vs those with secondary progressive MS (SPMS) to better elucidate the factors associated with a favorable status in patients with MS.

Design: Cross-sectional survey from January 2006 to August 2007.

CD4+CD25+FoxP3+PD1- regulatory T cells in acute and stable relapsing-remitting multiple sclerosis and their modulation by therapy.

The intracellular expression of the programmed death receptor 1 (PD1) identifies a subset of naive T(reg) cells with enhanced suppressive ability; antigen stimulation results in the surface expression of PD1. Because the role of T(reg) impairments in multiple sclerosis (MS) is still contradictory, we analyzed naive PD1- and PD1+ T(reg) cells in peripheral blood and cerebrospinal fluid (CSF) of relapsing-remitting multiple sclerosis (RR-MS) patients and of healthy control subjects. Results showed that 1) CSF PD1- T(reg) cells were significantly augmented in MS patients; 2) PD1- T(reg) cells were significantly increased in the peripheral blood of patients with stable disease (SMS) compared to those with acute (AMS) disease, and in patients responding to glatiramer acetate (COPA) compared to AMS- and COPA-unresponsive patients; and 3) PD1+ T(reg) cells were similar in CSF and peripheral blood of all groups analyzed.

Experience with two cases of intestinal tuberculosis: utility of the QuantiFERON-TB Gold test for diagnosis.

Background: Intestinal tuberculosis is rare in Western countries, with incidence rates of 35.7 and 0.43 per 100,000 per year for the immigrant and native populations, respectively.

Spinal fMRI during proprioceptive and tactile tasks in healthy subjects: Activity detected using cross-correlation, general linear model and independent component analysis.

Introduction: Functional MRI (fMRI) of the spinal cord is able to provide maps of neuronal activity. Spinal fMRI data have been analyzed in previous studies by calculating the cross-correlation (CC) between the stimulus and the time course of every voxel and, more recently, by using the general linear model (GLM). The aim of this study was to compare three different approaches (CC analysis, GLM and independent component analysis (ICA)) for analyzing fMRI scans of the cervical spinal cord.

Variations of the perforin gene in patients with multiple sclerosis.

Perforin is involved in cell-mediated cytotoxicity and mutations of its gene (PRF1) cause familial hemophagocytic lymphohistiocytosis (FLH2). PRF1 sequencing in 190 patients with multiple sclerosis and 268 controls detected two FLH2-associated variations (A91V, N252S) in both groups and six novel mutations (C999T, G1065A, G1428A, A1620G, G719A, C1069T) in patients. All together, carriers of these variations were more frequent in patients than in controls (phenotype frequency: 17 vs 9%, P=0.

Voxel-based analysis derived from fractional anisotropy images of white matter volume changes with aging.

Although age-related effects on brain volume have been extensively investigated post mortem and in vivo using magnetic resonance imaging (MRI), regional and temporal patterns of white matter (WM) volume changes with aging are not defined yet. The aim of this study was to assess the topographical distribution of age-related WM volume changes using a recently developed voxel-based method to obtain estimates of WM fiber bundle volumes using diffusion tensor (DT) MRI. Brain conventional and DT MRI were obtained from 84 healthy subjects (mean age=44 years, range=13-70).

Evidence for enhanced functional activity of cervical cord in relapsing multiple sclerosis.

Functional MRI (fMRI) was used to assess proprioceptive-associated cervical cord activity in 24 relapsing multiple sclerosis (MS) patients and 10 controls. Cord and brain conventional and diffusion tensor (DT) MRI were also acquired. fMRI was performed using a block design during a proprioceptive stimulation consisting of a passive flexion-extension of the right upper limb.