TY - JOUR
T1 - Cranial Nerve Enhancement in Multiple Sclerosis Is Associated With Younger Age at Onset and More Severe Disease
AU - Haider, Lukas
AU - Chan, Wei-Shin Evelyn
AU - Olbert, Elisabeth
AU - Mangesius, Stephanie
AU - Dal-Bianco, Assunta
AU - Leutmezer, Fritz
AU - Prayer, Daniela
AU - Thurnher, Majda
N1 - Funding Information:
LH was supported by the European Society of Neuroradiology (ESNR) Research Fellow Ship and the ECTRIMS/MAGNIMS Research Fellow Ship. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Funding Information:
We thank Tobias Zrzavy, MD, Ph.D. for MRI consensus rating and Prof. G. Kasprian, MD, Ph.D. for valuable expert feedback on MRI analysis. Funding. LH was supported by the European Society of Neuroradiology (ESNR) Research Fellow Ship and the ECTRIMS/MAGNIMS Research Fellow Ship. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Publisher Copyright:
© Copyright © 2019 Haider, Chan, Olbert, Mangesius, Dal-Bianco, Leutmezer, Prayer and Thurnher.
PY - 2019/11/6
Y1 - 2019/11/6
N2 - Background: The overall frequency of cranial nerve pathology, including cranial nerves other than the trigeminal nerve, as well as its relation to brainstem lesion formation on magnetic resonance imaging (MRI) and clinical correlates in multiple sclerosis (MS) is unknown. Objective: We aimed to determine the frequency of cranial nerve enhancement on MRI, and its association with brainstem lesion formation and clinical outcomes. Methods: We retrospectively analyzed, in 183 patients, (RRMS: 156, SPMS: 15, PPMS: 6, CIS: 6) 651 MRIs (76.5% on the identical scanner Siemens Trio Tim, 3T with identical MRI protocols). Frequencies of cranial nerve enhancement on post contrast T1-weighted MRIs were compared to lesion counts and the MS-severity-score. Results: Cranial nerve enhancement was present in 8.2% of the analyzed MS patients (oculomotor-nerve: 1.1%, trigeminal-nerve: 2.7%, abducens-nerve: 2.2%, facial-/vestibulocochlear nerve: 1.6%, vagal-nerve: 0.5%). Of those, 13% suffered from repeated episodes and 27% exhibited a cranial nerve enhancement duration of >12 months. Age at MS onset was lower in patients with cranial nerve enhancement, 23 vs. 28 years, p = 0.049. The MS-severity-score, 5.15 vs. 0.88 (p = 0.019), the T2 brainstem-, 1 vs. 0 (p = 0.041), and the total intracranial contrast-enhancing lesion counts, 2 vs. 0 (p = 0.000), were higher in patients with cranial nerve enhancement, compared to age-, disease duration-, and gender- matched MS patients. Conclusions: Cranial nerve enhancement, present in 8.2% of our patients, was associated with a younger age at MS onset, brainstem lesions, and a more severe disease course.
AB - Background: The overall frequency of cranial nerve pathology, including cranial nerves other than the trigeminal nerve, as well as its relation to brainstem lesion formation on magnetic resonance imaging (MRI) and clinical correlates in multiple sclerosis (MS) is unknown. Objective: We aimed to determine the frequency of cranial nerve enhancement on MRI, and its association with brainstem lesion formation and clinical outcomes. Methods: We retrospectively analyzed, in 183 patients, (RRMS: 156, SPMS: 15, PPMS: 6, CIS: 6) 651 MRIs (76.5% on the identical scanner Siemens Trio Tim, 3T with identical MRI protocols). Frequencies of cranial nerve enhancement on post contrast T1-weighted MRIs were compared to lesion counts and the MS-severity-score. Results: Cranial nerve enhancement was present in 8.2% of the analyzed MS patients (oculomotor-nerve: 1.1%, trigeminal-nerve: 2.7%, abducens-nerve: 2.2%, facial-/vestibulocochlear nerve: 1.6%, vagal-nerve: 0.5%). Of those, 13% suffered from repeated episodes and 27% exhibited a cranial nerve enhancement duration of >12 months. Age at MS onset was lower in patients with cranial nerve enhancement, 23 vs. 28 years, p = 0.049. The MS-severity-score, 5.15 vs. 0.88 (p = 0.019), the T2 brainstem-, 1 vs. 0 (p = 0.041), and the total intracranial contrast-enhancing lesion counts, 2 vs. 0 (p = 0.000), were higher in patients with cranial nerve enhancement, compared to age-, disease duration-, and gender- matched MS patients. Conclusions: Cranial nerve enhancement, present in 8.2% of our patients, was associated with a younger age at MS onset, brainstem lesions, and a more severe disease course.
UR - http://www.scopus.com/inward/record.url?scp=85075980378&partnerID=8YFLogxK
U2 - 10.3389/fneur.2019.01085
DO - 10.3389/fneur.2019.01085
M3 - Journal article
C2 - 31781014
SN - 1664-2295
VL - 10
SP - 1085
JO - Frontiers in Neurology
JF - Frontiers in Neurology
M1 - 1085
ER -