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Transcranial brain sonography findings predict disease progression in multiple sclerosis
Neurology, 08/07/09
Walter U et al. – Neurodegenerative disease–like deep gray matter lesions can be frequently detected by transcranial sonography (TCS) in pts with multiple sclerosis (MS). Findings suggest that TCS shows changes of brain iron metabolism that correlate with future progress of MS.
Methods- Study of whether TCS can also display deep gray matter lesions in pts with MS and of whether sonographic findings relate to severity and progression of MS
- Prospectively study of 75 pts with different courses of MS and 55 age-matched healthy subjects clinically and with TCS
- At time of TCS, 1.5-T MRI for 23 additional pts
- Clinical assessment of disease progression 2 yrs after TCS
- Abnormal hyperechogenicity of SN, lenticular nucleus (LN), caudate nucleus, and thalamus in 41%, 54%, 40%, and 8% of MS pts, with similar frequency in pts with relapsing-remitting and primary or secondary progressive MS if corrected for disease duration, but only in 13%, 13%, 5%, and none of control subjects
- Hyperechogenicity of SN and LN correlated with more pronounced MRI T2 hypointensity, possibly reflecting iron deposition
- Larger bilateral SN echogenic area related to higher rate of disease progression
- Small SN echogenic area (SN hypoechogenicity) predicted disease course without further progression within 2 yrs
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