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- Title
Treatment of multiple sclerosis relapses with high-dose methylprednisolone reduces the evolution of contrast-enhancing lesions into persistent black holes.
- Authors
Di Gregorio, Maria; Gaetani, Lorenzo; Eusebi, Paolo; Floridi, Piero; Picchioni, Antonella; Rosi, Giovanni; Mancini, Andrea; Floridi, Chiara; Baschieri, Francesca; Gentili, Lucia; Sarchielli, Paola; Calabresi, Paolo; Di Filippo, Massimiliano
- 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, <italic>p</italic> = 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, <italic>p</italic> < 0.001 and OR 13.19, 95% CI 1.56-288.87, <italic>p</italic> = 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.
- Subjects
MULTIPLE sclerosis treatment; DISEASE relapse; MAGNETIC resonance imaging; METHYLPREDNISOLONE; STEROIDS; THERAPEUTICS
- Publication
Journal of Neurology, 2018, Vol 265, Issue 3, p522
- ISSN
0340-5354
- Publication type
Article
- DOI
10.1007/s00415-017-8726-2