Treatment of multiple sclerosis relapses with high-dose methylprednisolone reduces the evolution of contrast-enhancing lesions into persistent black holes

Paolo Calabresi, Maria Di Gregorio, Lorenzo Gaetani, Paolo Eusebi, Piero Floridi, Antonella Picchioni, Giovanni Rosi, Andrea Mancini, Chiara Floridi, Francesca Baschieri, Lucia Gentili, Paola Sarchielli, Massimiliano Di Filippo

Risultato della ricerca: Contributo in rivistaArticolo in rivista

6 Citazioni (Scopus)

Abstract

Introduction: The MRI evidence of persistent black holes (pBHs) on T1-weighted images reflects brain tissue loss in multiple sclerosis (MS). The evolution of contrast-enhancing lesions (CELs) into pBHs probably depends on the degree and persistence of focal brain inflammation. The aim of our retrospective study was to evaluate the effect of a single cycle of intravenous methylprednisolone (IVMP), as for MS relapse treatment, on the risk of CELs’ evolution into pBHs. Patients and methods: We selected 57 patients with CELs on the baseline MRI scan. We evaluated the evolution of CELs into pBHs on a follow-up MRI scan performed after ≥ 6 months in patients exposed and not exposed to IVMP for the treatment of relapse after the baseline MRI. Results: In our cohort, 182 CELs were identified in the baseline MRI and 57 of them (31.3%) evolved into pBHs. In the multivariate analysis, the exposure of CELs to IVMP resulted to be a significant independent protective factor against pBHs’ formation (OR 0.28, 95% CI 0.11–0.766, p = 0.005), while ring enhancement pattern and the fact of being symptomatic were significant risk factors for CELs’ conversion into pBHs (OR 6.42, 95% CI 2.55–17.27, p OpenSPiltSPi 0.001 and OR 13.19, 95% CI 1.56–288.87, p = 0.037). Conclusions: The exposure of CELs to a cycle of IVMP as for relapse treatment is associated with a lower risk of CELs’ evolution into pBHs. Future studies are required to confirm the potential independent protective effect of IVMP on CELs’ evolution into pBHs.
Lingua originaleEnglish
pagine (da-a)522-529
Numero di pagine8
RivistaJournal of Neurology
Volume265
DOI
Stato di pubblicazionePubblicato - 2018

Keywords

  • Adolescent
  • Adult
  • Aged
  • Black holes
  • Brain
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Glucocorticoids
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Methylprednisolone
  • Middle Aged
  • Multiple Sclerosis, Relapsing-Remitting
  • Multiple sclerosis
  • Multivariate Analysis
  • Neuroprotective Agents
  • Retrospective Studies
  • Steroid
  • Treatment Outcome
  • Young Adult

Fingerprint

Entra nei temi di ricerca di 'Treatment of multiple sclerosis relapses with high-dose methylprednisolone reduces the evolution of contrast-enhancing lesions into persistent black holes'. Insieme formano una fingerprint unica.

Cita questo