Journal Article

Spatiotemporal distribution of white matter lesions in relapsing–remitting and secondary progressive multiple sclerosis

Radue, Ernst-Wilhelm, Polman, Chris, Mueller-Lenke, Nicole, Nichols, Thomas E, Traud, Stefan, Gass, Achim, Borgwardt, Stefan J, Kappos, Ludwig, Kuster, Pascal, Hofstetter, Louis, Bendfeldt, Kerstin, Filli, Lukas, Sprenger, Till, Vrenken, Hugo, Naegelin, Yvonne, Barkhof, Frederik

2012

Overview

Background: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. MS lesions show a typical distribution pattern and primarily affect the white matter (WM) in the periventricular zone and in the centrum semiovale. Objective: To track lesion development during disease progression, we compared the spatiotemporal distribution patterns of lesions in relapsing–remitting MS (RRMS) and secondary progressive MS (SPMS). Methods: We used T1 and T2 weighted MR images of 209 RRMS and 62 SPMS patients acquired on two different 1.5 Tesla MR scanners in two clinical centers followed up for 25 (± 1.7) months. Both cross-sectional and longitudinal differences in lesion distribution between RRMS and SPMS patients were analyzed with lesion probability maps (LPMs) and permutation-based inference. Results: MS lesions clustered around the lateral ventricles and in the centrum semiovale. Cross-sectionally, compared to RRMS patients, the SPMS patients showed a significantly higher regional probability of T1 hypointense lesions (p≤0.03) in the callosal body, the corticospinal tract, and other tracts adjacent to the lateral ventricles, but not of T2 lesions (peak probabilities were RRMS: T1 9%, T2 18%; SPMS: T1 21%, T2 27%). No longitudinal changes of regional T1 and T2 lesion volumes between baseline and follow-up scan were found. Conclusion: The results suggest a particular vulnerability to neurodegeneration during disease progression in a number of WM tracts.

• Publisher: SAGE Publications,Sage Publications,Sage Publications Ltd
• Subject: Adult / Analysis of Variance / Biological and medical sciences / Brain - pathology / Chi-Square Distribution / Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases / Disability Evaluation / Disease Progression / Europe / Female / Humans / Leukoencephalopathies - pathology / Magnetic Resonance Imaging / Male / Medical sciences / Middle Aged / Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis / Multiple Sclerosis, Chronic Progressive - pathology / Multiple Sclerosis, Relapsing-Remitting - pathology / Neurology / Predictive Value of Tests / Time Factors