MRI monitoring of pathological changes in the spinal cord in patients with multiple sclerosis

Gass, Achim, Rocca, Maria A., Agosta, Federica, Ciccarelli, Olga, Chard, Declan, Valsasina, Paola, Brooks, Jonathan C.W. ORCID: https://orcid.org/0000-0003-3335-6209, Bischof, Antje, Eisele, Philipp, Kappos, Ludwig, Barkhof, Frederik and Filippi, Massimo (2015) MRI monitoring of pathological changes in the spinal cord in patients with multiple sclerosis. The Lancet Neurology, 14 (4). pp. 443-454. ISSN 1474-4422

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Abstract

The spinal cord is a clinically important site that is affected by pathological changes in most patients with multiple sclerosis; however, imaging of the spinal cord with conventional MRI can be difficult. Improvements in MRI provide a major advantage for spinal cord imaging, with better signal-to-noise ratio and improved spatial resolution. Through the use of multiplanar MRI, identification of diffuse and focal changes in the whole spinal cord is now routinely possible. Corroborated by related histopathological analyses, several new techniques, such as magnetisation transfer, diffusion tension imaging, functional MRI, and proton magnetic resonance spectroscopy, can detect non-focal, spinal cord pathological changes in patients with multiple sclerosis. Additionally, functional MRI can reveal changes in the response pattern to sensory stimulation in patients with multiple sclerosis. Through use of these techniques, findings of cord atrophy, intrinsic cord damage, and adaptation are shown to occur largely independently of focal spinal cord lesion load, which emphasises their relevance in depiction of the true burden of disease. Combinations of magnetisation transfer ratio or diffusion tension imaging indices with cord atrophy markers seem to be the most robust and meaningful biomarkers to monitor disease evolution in early multiple sclerosis.

Item Type: Article
Additional Information: Funding Information: AG has received honoraria for lecturing, travel expenses for attending meetings, and financial support for research from Bayer Schering, Biogen Idec, Merck Serono, Novartis, and TEVA Neurosciences. FA has received research supports from the Italian Ministry of Health and AriSLA—Fondazione Italiana di Ricerca per la Sclerosi Laterale Amiotrofica, and speaker honoraria from Biogen Idec and Serono Symposia International Foundation. DC has received honoraria from Bayer, Teva and the Serono Symposia International Foundation for faculty-led education work, Teva for advisory board work, and holds stock in GlaxoSmithKline. MAR has received speaker honoraria from Biogen Idec, Serono Symposia International Foundation, Genzyme, and Novartis and receives research support from Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla. MF serves on scientific advisory boards for Teva Pharmaceutical Industries; has received compensation for consulting services and/or speaking activities from Bayer Schering Pharma, Biogen Idec, Merck Serono, and Teva Pharmaceutical Industries; and receives research support from Bayer Schering Pharma, Biogen Idec, Merck Serono, Teva Pharmaceutical Industries, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, Cure PSP, Alzheimer's and Drug Discovery Foundation, and the Jacques and Gloria Gossweiler Foundation (Switzerland). OC has received research funding from the Wellcome Trust, MS Society of Great Britain and Northern Ireland, UCL Biomedical Research Centre, and Engineering and Physical Sciences Research Council. She has also received speaker honoraria from Bayer. AB received travel support from Biogen Idec. PE has received travel expenses from Bayer Health Care. FB serves as a consultant for Bayer Shering Pharma, Sanofi-Aventis, Biogen-Idec, UCB, Merck-Serono, Novartis, and Roche. LK has participated in the past 36 months as member or chair of planning and steering committees or advisory boards in corporate-sponsored clinical trials in multiple sclerosis and other neurological diseases. The sponsoring pharmaceutical companies for these trials include: Actelion, Addex, Advancell, Allozyne, BaroFold, Bayer Health Care Pharmaceuticals, Bayer Schering Pharma, Bayhill, Biogen Idec, Biotica, CLC Behring, Elan, Genentech, GeNeuro SA, Genmab, Genmark, Genzyme, GlaxoSmithKline, Johnson & Johnson, Lilly, Merck Serono, Mitsubishi Pharma, Novartis, Novo Nordisk, Octapharma, Peptimmune, Praxicon, Roche, Sanofi-Aventis, Santhera, Siemens, Teva, UCB, Xenoport and Wyeth. He is principal investigator for the following drug studies: BOLD, BOLD EXT., EXPAND (BAF312, Novartis), DECIDE, DECIDE EXT. (Daclizumab, Biogen Idec), ENDORSE (BG00012, Biogen Idec), FINGORETT, FTY-UMBRELLA, INFORMS, INFORMS EXT LONGTERM. (Fingolimod, Novartis), OCRELIZUMAB PHASE II EXT., OPERA, ORATORIO (Ocrelizumab, Roche), STRATA EXT. (Natalizumab, Biogen Idec), and TERIFLUNOMIDE EXT. (Teriflunomide, Sanofi-Aventis). He has also lectured at medical conferences or in public on various aspects of the diagnosis and management of multiple sclerosis. In many cases these talks have been sponsored by unrestricted educational grants to his institution from one or another of the above listed companies. Honoraria and other payments for all these activities have been exclusively used for funding of research of his department. JCWB and PV declare no competing interests. Publisher Copyright: © 2015 Elsevier Ltd.
Uncontrolled Keywords: clinical neurology ,/dk/atira/pure/subjectarea/asjc/2700/2728
Faculty \ School: Faculty of Social Sciences > School of Psychology
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Depositing User: LivePure Connector
Date Deposited: 07 Sep 2022 11:31
Last Modified: 23 Sep 2022 02:44
URI: https://ueaeprints.uea.ac.uk/id/eprint/87790
DOI: 10.1016/S1474-4422(14)70294-7

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