Publications by authors named "Ontaneda D"
Background And Purpose: The central vein sign (CVS) is a diagnostic imaging biomarker for multiple sclerosis (MS). FLAIR* is a combined MRI contrast that provides high conspicuity for CVS at 3 Tesla (3T), enabling its sensitive and accurate detection in clinical settings. This study evaluated whether CVS conspicuity of 3T FLAIR* is reliable across imaging sites and MRI vendors and whether gadolinium (Gd) contrast increases CVS conspicuity.
View Article and Find Full Text PDFBackground: Little is known about how multiple sclerosis (MS) presents in Hispanic/Latinx (HL) people with MS (pwMS).
Objective: Compare age at onset (AAO) and onset severity between HL versus non-Hispanic White (NHW) pwMS.
Methods: A cross-sectional study leveraged the MS PATHS registry spanning seven US tertiary care institutions.
Incorporation of the central vein sign into the McDonald criteria.
Mult Scler Relat Disord
January 2025
Background: Diagnosis of multiple sclerosis (MS) frequently relies on MRI dissemination in time (DIT) and space (DIS), as codified in 2017 McDonald criteria (McD 2017). The central vein sign (CVS) is a proposed MS diagnostic biomarker, but its optimal incorporation into McD 2017 has not been extensively studied.
Objective: Evaluate the diagnostic performance of several methods incorporating CVS into McD 2017 radiological DIS criteria.
Background: A digital adaptation of the nine-hole peg test (9HPT) was developed with the potential to provide novel disability features for patients with multiple sclerosis (PwMS).
Objectives: The objectives were to evaluate the 9HPT features based on reliability, prognosis, and discrimination between treatment groups.
Methods: The MS partners Advancing Technology and Health Solutions (MS PATHS) cohort data were used to derive new features including completion time and speed.
Background And Objectives: To characterize outpatient telemedicine utilization for neurologic conditions and identify potential disparities.
Methods: All outpatient visits conducted by neurology clinicians at an academic medical health care system for patients aged 18 years or older from January 2019 to July 2022 were included. All telemedicine visits were synchronous audio-visual.
Article Synopsis
- Patients with neuromyelitis optica spectrum disorder (NMOSD) often have antibodies against aquaporin-4 (AQP4), making MRI monitoring critical for understanding the disease's progression.
- A retrospective study involved MRI data from 525 AQP4-IgG-seropositive NMOSD patients across 11 countries, focusing on the types and locations of lesions in the central nervous system.
- Results showed a high prevalence of hyperintense lesions in the brain and significant patterns of myelitis in the spinal cord, emphasizing the importance of MRI in tracking this condition.
The use of ultra-high-field 7-Tesla (7T) MRI in multiple sclerosis (MS) research has grown significantly over the past two decades. With recent regulatory approvals of 7T scanners for clinical use in 2017 and 2020, the use of this technology for routine care is poised to continue to increase in the coming years. In this context, the North American Imaging in MS Cooperative (NAIMS) convened a workshop in February 2023 to review the previous and current use of 7T technology for MS research and potential future research and clinical applications.
View Article and Find Full Text PDFBackground: While standard clinical assessments provide great value for people with multiple sclerosis (PwMS), they are limited in their ability to characterize patient perspectives and individual-level symptom heterogeneity.
Objectives: To identify PwMS subgroups based on patient-reported outcomes (PROs) of physical, cognitive, and emotional symptoms. We also sought to connect PRO-based subgroups with demographic variables, functional impairment, hypertension and smoking status, traditional qualitative multiple sclerosis (MS) symptom groupings, and neuroperformance measurements.
Background And Purpose: Paramagnetic rim lesions (PRLs) are an MRI biomarker of chronic inflammation in people with multiple sclerosis (MS). PRLs may aid in the diagnosis and prognosis of MS. However, manual identification of PRLs is time-consuming and prone to poor interrater reliability.
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- * Recently, there have been great breakthroughs for MS, with new medications being approved, but people with PD still have not gotten new treatments and only have old ones that don't work as well.
- * Experts from around the world gathered in Toronto to discuss how to improve treatment for PD by learning from what worked for MS, focusing on things like better clinical trials and understanding the diseases better.
Article Synopsis
- The central vein sign (CVS) is a proposed biomarker for diagnosing multiple sclerosis (MS) but traditional manual ratings for assessing CVS lesions can be slow and inconsistent.
- This study compared an automated CVS detection method to manual rating in 86 participants being evaluated for MS using 3T MRI scans.
- Results showed the automated method had a similar effectiveness in distinguishing MS patients from non-patients as the manual methods, with an area under the curve (AUC) ranging between 0.78 and 0.89, depending on the method used.
The differential diagnosis of suspected multiple sclerosis has been developed using data from North America, northern Europe, and Australasia, with a focus on White populations. People from minority ethnic and racial backgrounds in regions where prevalence of multiple sclerosis is high are more often negatively affected by social determinants of health, compared with White people in these regions. A better understanding of changing demographics, the clinical characteristics of people from minority ethnic or racial backgrounds, and the social challenges they face might facilitate equitable clinical approaches when considering a diagnosis of multiple sclerosis.
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- The study investigates how teleneurology affects healthcare utilization (HCU) for patients with multiple sclerosis (MS) and clinically isolated syndrome (CIS) in the Cleveland/Akron area from July 2020 to July 2022.
- Findings show that patients using teleneurology had more visits but required fewer laboratory and MRI orders, indicating efficient use of healthcare resources.
- Despite the increased visit volumes, there was no rise in emergency care utilization, although higher emergency visits were noted among Black and Medicaid patients, highlighting a need for further research.
Background: Loss of mobility is common in persons with multiple sclerosis (PwMS), but little is known about this impairment from the patient's perspective.
Objective: The aim is to model longitudinal variation in a mobility patient-reported outcome (PRO) and compare trajectories to those observed for Timed 25-Foot Walk (T25FW) in a retrospective cohort.
Methods: Latent-class growth analysis was applied to 47,508 measures of Performance Scales© Mobility PRO (PS-Mobility) over ~4 years for 8524 PwMS.
Article Synopsis
- The study evaluates the effectiveness of simplified imaging methods (central vein sign or CVS) compared to cerebrospinal fluid oligoclonal bands (OCB) as diagnostic tools for multiple sclerosis (MS).
- Results indicate that both methods have similar sensitivity and specificity, with a higher positive predictive value (PPV) for the CVS method after 12 months.
- Further research is planned to determine if CVS can replace or work alongside OCB for diagnosing MS.
Article Synopsis
- The study investigates the mechanisms behind neurological disabilities in progressive multiple sclerosis (PMS), focusing on myelocortical MS (MCMS) and its distinct characteristics compared to typical MS (TMS).
- Researchers analyzed postmortem brain samples to understand the distribution and pathology of myelinated lesions, developing an MRI classifier that accurately differentiates between MCMS and TMS cases.
- Findings suggest that a significant portion of living PMS patients displays limited cerebral white matter demyelination, challenging the notion that WM demyelination is the primary factor in disability progression and impacting clinical management strategies.
Background: Effective communication between providers and people with multiple sclerosis (pwMS) is essential.
Objectives: To determine the level of concordance between provider- and pwMS-reported disease course.
Methods: Patient encounters from December 2015 through April 2020 were retrospectively reviewed for MS disease course self-reported by the patient and separately documented by the provider at each visit.
In this paper, we analyse the different advances in artificial intelligence (AI) approaches in multiple sclerosis (MS). AI applications in MS range across investigation of disease pathogenesis, diagnosis, treatment, and prognosis. A subset of AI, Machine learning (ML) models analyse various data sources, including magnetic resonance imaging (MRI), genetic, and clinical data, to distinguish MS from other conditions, predict disease progression, and personalize treatment strategies.
View Article and Find Full Text PDFBackground And Objectives: Up to 65% of people with multiple sclerosis (MS) experience disease-related cognitive impairment, but even after decades of research, still very little is known about the cognitive issues among older adults with MS (EwMS; individuals aged 60+). To date, few studies have attempted to characterize cognitive impairment in this group or compare EwMS with those with other neurodegenerative diseases. Our goal was to address this knowledge gap by comparing EwMS with individuals experiencing cognitive impairment due to probable Alzheimer disease (AD) with biomarker confirmation.
View Article and Find Full Text PDFBackground And Purpose: Slowly expanding lesions (SELs) are thought to represent a subset of chronic active lesions and have been associated with clinical disability, severity, and disease progression. The purpose of this study was to characterize SELs using advanced magnetic resonance imaging (MRI) measures related to myelin and neurite density on 7 Tesla (T) MRI.
Methods: The study design was retrospective, longitudinal, observational cohort with multiple sclerosis (n = 15).
Background: Cognitive impairment (CI) is common in multiple sclerosis (MS). Processing speed (PS) is often affected, making it an ideal target for monitoring CI. This study aims to evaluate the association between disease-modifying therapy (DMT) use and intensity and longitudinal changes in Processing Speed Test (PST) scores for individuals with MS.
View Article and Find Full Text PDFBackground: Cognitive dysfunction is a known symptom of multiple sclerosis (MS), with memory recognized as a frequently impacted domain. Here, we used high-resolution MRI at 7 tesla to build on cross-sectional work by evaluating the longitudinal relationship of diffusion tensor imaging (DTI) measures of the fornix to episodic memory performance.
Methods: A sample of 80 people with multiple sclerosis (mean age 51.