Biomedical subjects

Matilde Inglese

Publications and source records attributed to Matilde Inglese.

22 records · Page 2Linked to original sources

PubMed2002

Irreversible disability and tissue loss in multiple sclerosis: a conventional and magnetization transfer magnetic resonance imaging study of the optic nerves.

OBJECTIVES: To assess, by magnetic resonance imaging, the volumes and magnetization transfer ratio (MTR) values of optic nerves (ONs) from patients with multiple sclerosis (MS) who had incomplete or no visual recovery after optic neuritis; and to compare these quantities with those derived from ONs from patients with MS who showed a marked clinical recovery after optic neuritis, ONs from healthy volunteers, and ONs from patients with Leber hereditary optic neuropathy (LHON). METHODS: Conventional and magnetization transfer magnetic resonance images of the ONs were obtained from 30 patients with MS, 18 healthy volunteers, and 10 patients with LHON. The ON from patients with MS were classified as clinically unaffected (n = 18); clinically affected with recovery (n = 20; visual acuity > or =20/25 at least 6 months after optic neuritis); and clinically affected with incomplete or no recovery (n = 22; visual acuity <20/25 at least 6 months after optic neuritis). The ON volumes and MTR values were measured. RESULTS: Volumes (P =.002) and MTR values (P<.001) of the ONs from patients with MS and incomplete or no recovery were both lower than those of the ONs from patients with MS and recovery, but not different from those of the ONs from patients with LHON. Volumes and MTR values of the affected ONs from patients with MS and recovery did not differ from those of clinically unaffected ONs, which were similar to those of healthy volunteers. CONCLUSION: These findings suggest that, in patients with MS, neurodegeneration is associated with persistent functional deficits secondary to incomplete recovery from relapses.

Adolescent↗

PubMed2002

Magnetization transfer and diffusion tensor MR imaging of acute disseminated encephalomyelitis.

BACKGROUND AND PURPOSE: Patients with acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) have a similar pattern of abnormalities on conventional MR images. We used magnetization transfer and diffusion tensor MR imaging to quantify normal-appearing brain tissue and cervical cord disease in patients with ADEM and to compare findings with those in healthy volunteers and patients with MS. METHODS: Brain dual-echo, T1-weighted magnetization transfer, and diffusion tensor images were obtained in eight patients with ADEM, in 10 patients with MS, and in 10 healthy volunteers. Fast short-tau inversion recovery, T1-weighted, and magnetization transfer cervical cord images were also obtained. We identified lesions on the images and quantified their volumes. We performed histogram analysis of the magnetization transfer ratio (MTR) and average mean histogram analysis of the diffusivity (D) in normal-appearing brain tissue and MTR in the cervical cord. RESULTS: Histogram analysis of normal-appearing brain tissue in patients with MS showed significantly lower MTRs and peak positions and significantly higher D averages compared with those in patients with ADEM. Patients with MS had significantly lower MTRs and D peak heights and significantly higher average D compared with those in healthy volunteers. Between patients with ADEM and control subjects, normal-appearing brain tissue MTR and D histogram metrics did not differ significantly. Cervical cord MTRs did not differ between control subjects and patients with ADEM, whereas the average MTR and histogram peak position was significantly lower in patients with MS than in the other groups. CONCLUSION: Outside the acute phase of disease and as opposed to what happens in MS, the normal-appearing brain tissue and cervical cord in patients with ADEM are spared in the pathologic process.

Adult↗

PubMed2001

Growing Region Segmentation Software (GRES) for quantitative magnetic resonance imaging of multiple sclerosis: intra- and inter-observer agreement variability: a comparison with manual contouring method.

Lesion area measurement in multiple sclerosis (MS) is one of the key points in evaluating the natural history and in monitoring the efficacy of treatments. This study was performed to check the intra- and inter-observer agreement variability of a locally developed Growing Region Segmentation Software (GRES), comparing them to those obtained using manual contouring (MC). From routine 1.5-T MRI study of clinically definite multiple sclerosis patients, 36 lesions seen on proton-density-weighted images (PDWI) and 36 enhancing lesion on Gd-DTPA-BMA-enhanced T1-weighted images (Gd-T1WI) were randomly chosen and were evaluated by three observers. The mean range of lesion size was 9.9-536.0 mm(2) on PDWI and 3.6-57.2 mm(2) on Gd-T1WI. The median intra- and inter-observer agreement were, respectively, 97.1 and 90.0% using GRES on PDWI, 81.0 and 70.0% using MC on PDWI, 88.8 and 80.0% using GRES on Gd-T1WI, and 85.8 and 70.0% using MC on Gd-T1WI. The intra- and inter-observer agreements were significantly greater for GRES compared with MC ( P<0.0001 and P=0.0023, respectively) for PDWI, while no difference was found between GRES an MC for Gd-T1WI. The intra-observer variability for GRES was significantly lower on both PDWI ( P=0.0001) and Gd-T1WI ( P=0.0067), whereas for MC the same result was found only for PDWI ( P=0.0147). These data indicate that GRES reduces both the intra- and the inter-observer variability in assessing the area of MS lesions on PDWI and may prove useful in multicentre studies.

Algorithms↗

PubMedDate not supplied

Interferon beta-1a for brain tissue loss in patients at presentation with syndromes suggestive of multiple sclerosis: a randomised, double-blind, placebo-controlled trial.

BACKGROUND: In patients who present with clinically isolated syndromes suggestive of multiple sclerosis, interferon beta-1a is effective in delaying evolution to clinically definite disease and in reducing MRI-measured disease activity. We aimed to assess whether this drug can also reduce the rate of brain volume decrease in such patients enrolled in the ETOMS (early treatment of multiple sclerosis) trial. METHODS: MRI data for brain volume measurements at baseline, month 12, and month 24 were available from 131, 111, and 112 patients assigned treatment (22 microg interferon beta-1a), and 132, 98, and 99 patients assigned placebo respectively. Normalised brain parenchymal volume (NBV) at baseline and percentage brain volume changes (PBVC) were measured with a fully-automated segmentation technique. The primary endpoint was conversion to clinically definite multiple sclerosis due to clinical relapse. Analysis was by intention to treat. FINDINGS: 41 (31%) of 131 patients on interferon beta-1a and 62 (47%) of 132 on placebo converted to clinically definite multiple sclerosis (odds ratio 0.52 [95% CI 0.31-0.86], p=0.0115). Mean PBVC for patients on placebo was -0.83% during the first year, -0.67% during the second year, and -1.68% during the entire study period. Respective values for treated patients were -0.62%, -0.61%, and -1.18%. The changes in brain volume were significant in both groups at all timepoints. A significant treatment effect was detected for month 24 versus baseline values (p=0.0031). The number of new T2 lesions formed during the first year correlated weakly with PBVC during the second year. INTERPRETATION: Early treatment with interferon beta-1a is effective in reducing conversion to clinically definite multiple sclerosis and in slowing progressive loss of brain tissue in patients with clinically isolated syndromes. The modest correlation between new lesion formation and brain volume decrease suggests that inflammatory and neurodegenerative processes are, at least partly, dissociated from the earliest clinical stage of multiple sclerosis onwards.

Adolescent↗