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01-03-2018 | Original Communication

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

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

Published in: Journal of Neurology | Issue 3/2018

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 < 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.

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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: Maria Di Gregorio
Lorenzo Gaetani
Paolo Eusebi
Piero Floridi
Antonella Picchioni
Giovanni Rosi
Andrea Mancini
Chiara Floridi
Francesca Baschieri
Lucia Gentili
Paola Sarchielli
Paolo Calabresi
Massimiliano Di Filippo
Publication date: 01-03-2018
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 3/2018
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-017-8726-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Introduction

Patients and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Patients and methods

Results

Conclusions

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