Discontinuation of First-Line Disease-Modifying Therapy in Patients With Stable Multiple Sclerosis: The DOT-MS Randomized Clinical Trial.

Importance: Increasing numbers of people with multiple sclerosis (MS) use disease-modifying therapy (DMT). Long-term stable disease while taking such medications provides a rationale for considering DMT discontinuation given patient burden, costs, and potential adverse effects of immunomodulating therapy.

Objective: To investigate whether first-line DMT can be safely discontinued in patients with long-term stable MS.

Serum neurofilament light and glial fibrillary acidic protein levels are not associated with wearing-off symptoms in natalizumab-treated multiple sclerosis patients.

Background: Biomarkers of neuronal and axonal damage (serum neurofilament light (sNfL) and serum glial fibrillary acidic protein (sGFAP)) may provide insight into the aetiology of natalizumab wearing-off symptoms (WoSs).

Objectives: We investigated the longitudinal association between and predictive value of sNfL and sGFAP and the occurrence of WoS in MS patients treated with natalizumab.

Methods: We performed longitudinal measurements of sNfL and sGFAP in NEXT-MS trial participants who completed a questionnaire about WoS.

Prospective trial of natalizumab personalised extended interval dosing by therapeutic drug monitoring in relapsing-remitting multiple sclerosis (NEXT-MS).

Background: Extended interval dosing (EID) of natalizumab is a promising strategy to optimise treatment in multiple sclerosis (MS). Personalised EID by therapeutic drug monitoring can enable further extension of treatment intervals.

Methods: The NEXT-MS trial is an investigator-initiated prospective phase IV non-randomised study.

Automated White Matter Hyperintensity Segmentation Using Bayesian Model Selection: Assessment and Correlations with Cognitive Change.

Accurate, automated white matter hyperintensity (WMH) segmentations are needed for large-scale studies to understand contributions of WMH to neurological diseases. We evaluated Bayesian Model Selection (BaMoS), a hierarchical fully-unsupervised model selection framework for WMH segmentation. We compared BaMoS segmentations to semi-automated segmentations, and assessed whether they predicted longitudinal cognitive change in control, early Mild Cognitive Impairment (EMCI), late Mild Cognitive Impairment (LMCI), subjective/significant memory concern (SMC) and Alzheimer's (AD) participants.

Microbleeds colocalize with enlarged juxtacortical perivascular spaces in amnestic mild cognitive impairment and early Alzheimer's disease: A 7 Tesla MRI study.

MRI-visible perivascular spaces (PVS) in the semioval centre are associated with cerebral amyloid angiopathy (CAA), but it is unknown if PVS co-localize with MRI markers of CAA. To examine this, we assessed the topographical association between cortical cerebral microbleeds (CMBs) - as an indirect marker of CAA - and dilatation of juxtacortical perivascular spaces (jPVS) in 46 patients with amnestic mild cognitive impairment (aMCI) or early Alzheimer's disease (eAD). The degree of dilatation of jPVS <1 cm around each cortical CMBs was compared with a similar reference site (no CMB) in the contralateral hemisphere, using a 4-point scale.

Abnormalities of Cerebral Deep Medullary Veins on 7 Tesla MRI in Amnestic Mild Cognitive Impairment and Early Alzheimer's Disease: A Pilot Study.

Cerebral small vessel disease (SVD) contributes to cognitive impairment and dementia. SVD may affect veins, but veins are difficult to detect with 1.5 and 3T MRI.

Robustness of Automated Methods for Brain Volume Measurements across Different MRI Field Strengths.

Introduction: Pooling of multicenter brain imaging data is a trend in studies on ageing related brain diseases. This poses challenges to MR-based brain segmentation. The performance across different field strengths of three widely used automated methods for brain volume measurements was assessed in the present study.

Perivascular spaces on 7 Tesla brain MRI are related to markers of small vessel disease but not to age or cardiovascular risk factors.

Cerebral perivascular spaces (PVS) are small physiological structures around blood vessels in the brain. MRI visible PVS are associated with ageing and cerebral small vessel disease (SVD). 7 Tesla (7T) MRI improves PVS detection.

Quantification of deep medullary veins at 7 T brain MRI.

Objectives: Deep medullary veins support the venous drainage of the brain and may display abnormalities in the context of different cerebrovascular diseases. We present and evaluate a method to automatically detect and quantify deep medullary veins at 7 T.

Methods: Five participants were scanned twice, to assess the robustness and reproducibility of manual and automated vein detection.

MRBrainS Challenge: Online Evaluation Framework for Brain Image Segmentation in 3T MRI Scans.

Many methods have been proposed for tissue segmentation in brain MRI scans. The multitude of methods proposed complicates the choice of one method above others. We have therefore established the MRBrainS online evaluation framework for evaluating (semi)automatic algorithms that segment gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) on 3T brain MRI scans of elderly subjects (65-80 y).

Cerebral amyloid angiopathy severity is linked to dilation of juxtacortical perivascular spaces.

Perivascular spaces are an emerging marker of small vessel disease. Perivascular spaces in the centrum semiovale have been associated with cerebral amyloid angiopathy. However, a direct topographical relationship between dilated perivascular spaces and cerebral amyloid angiopathy severity has not been established.

Bayesian model selection for pathological neuroimaging data applied to white matter lesion segmentation.

In neuroimaging studies, pathologies can present themselves as abnormal intensity patterns. Thus, solutions for detecting abnormal intensities are currently under investigation. As each patient is unique, an unbiased and biologically plausible model of pathological data would have to be able to adapt to the subject's individual presentation.

Bayesian model selection for pathological data.

The detection of abnormal intensities in brain images caused by the presence of pathologies is currently under great scrutiny. Selecting appropriate models for pathological data is of critical importance for an unbiased and biologically plausible model fit, which in itself enables a better understanding of the underlying data and biological processes. Besides, it impacts on one's ability to extract pathologically meaningful imaging biomarkers.

Cognitive disorders after sporadic ecstasy use? A case report.

Memory problems and changes in hippocampal structures after chronic ecstasy use are well described in the literature. Cognitive problems after incidental ecstasy use are rare, and the few patients described in case reports returned to their normal cognitive level after a relative short period. FV is a 39-year-old man who used an ecstasy tablet in 2005.

Cerebral microbleeds are not associated with long-term cognitive outcome in patients with transient ischemic attack or minor stroke.

Background: Cerebral microbleeds have been related to cerebrovascular disease and dementia. They occur more frequently in patients with ischemic stroke than in the general population, but their relation to cognition in these patients is uncertain, particularly in the long run. We examined the relationship between microbleeds in patients with a transient ischemic attack (TIA) or minor ischemic stroke, and cognitive performance 4 years later.

Visualization of perivascular spaces and perforating arteries with 7 T magnetic resonance imaging.

Objectives: The objectives of this study were to explore the possibilities of 7 T brain magnetic resonance imaging to visualize perivascular spaces (PVS) and to depict their related blood vessels.

Materials And Methods: Five subjects aged 19 to 27 years and 5 subjects aged 51 to 72 years were scanned. High-resolution 3-dimensional T1-, T2-, as well as T2*-weighted sequences and time-of-flight angiography were used for the visualization of PVS, veins, and perforating arteries.

Microbleeds as a predictor of intracerebral haemorrhage and ischaemic stroke after a TIA or minor ischaemic stroke: a cohort study.

Objectives: We examined whether patients with cerebral microbleeds on MRI, who started and continued antithrombotic medication for years, have an increased risk of symptomatic intracerebral haemorrhage (ICH).

Design: Prospective cohort study.

Settings: Multicentre outpatient clinics in the Netherlands.

Associations between retinal microvascular changes and dementia, cognitive functioning, and brain imaging abnormalities: a systematic review.

Retinal microvascular changes can be visualized noninvasively and have been associated with cognitive decline and brain changes in relation to aging and vascular disease. We systematically reviewed studies, published between 1990 and November 2012, on the association between retinal microvascular changes and dementia, cognitive functioning, and brain imaging abnormalities, in the context of aging and vascular risk factors. In cross-sectional studies (k=26), retinal microvascular changes were associated with the presence of dementia (range of odds ratios (ORs) 1.

Acute spinal-cord ischemia: evolution of MRI findings.

Background And Purpose: Magnetic resonance (MR) findings in acute spinal-cord ischemia can be summarized as focal cord enlargement and hyperintensities on T2-weighted images and gadolinium enhancement, especially of the central gray matter. However, in analogy with acute brain ischemia, it is to be expected that the findings of MR imaging (MRI) may be normal in the first hours after symptom onset. We evaluated the clinical and MRI findings in a series of patients with acute spinal-cord ischemia, and tested the hypothesis that the development and course of MR abnormalities are predictable.