DIR Return Create A Forum - Home
       ---------------------------------------------------------
       MS Speaks
  HTML https://msspeaks.createaforum.com
       ---------------------------------------------------------
       *****************************************************
   DIR Return to: TYSABRI (natalizumab)
       *****************************************************
       #Post#: 886--------------------------------------------------
       (Abst.) [Early identification of PML in patients on Tysabri]
   DIR By: agate
       Date: August 3, 2015, 7:39 pm
       ---------------------------------------------------------
       From PubMed via the MS International Federation News, July 27,
       2015:
       --- Quote ---
       > J Neurol Neurosurg Psychiatry. 2015 Jul;86(7):793-8.
       >
       > MRI pattern in asymptomatic natalizumab-associated PML
       >
       > Wattjes MP1, Vennegoor A2, Steenwijk MD1, de Vos M1,
       Killestein J2, van Oosten BW2, Mostert J3, Siepman DA4, Moll W5,
       van Golde AE6, Frequin ST7, Richert ND8, Barkhof F1.
       >
       > Author information
       >
       > 1Department of Radiology and Nuclear Medicine, MS Center
       Amsterdam, VU University Medical Center, Amsterdam, The
       Netherlands.
       > 2Department of Neurology, MS Center Amsterdam, VU University
       Medical Center, Amsterdam, The Netherlands.
       > 3Department of Neurology, Rijnstate Hospital, Arnhem, The
       Netherlands.
       > 4Department of Neurology, Erasmus MC, University Medical
       Center Rotterdam, MS Center, Rotterdam, The Netherlands.
       > 5Department of Neurology, Maasstad Hospital, Rotterdam, The
       Netherlands.
       > 6Department of Neurology, GT Hospital Almelo, Almelo, The
       Netherlands.
       > 7Department of Neurology, St. Antonius Hospital, Nieuwegein,
       The Netherlands.
       > 8Multiple Sclerosis Clinical Development Group, Biogen Idec,
       Cambridge, Massachusetts, USA.
       >
       > OBJECTIVE:
       >
       > To investigate the MRI manifestation pattern of asymptomatic
       natalizumab-associated progressive multifocal
       leukoencephalopathy (PML) in patients with multiple sclerosis
       (MS).
       >
       > METHODS:
       >
       > 18 patients with MS with natalizumab-associated PML lesions on
       MRI were included. In 6 patients, the PML lesions were
       identified on MRI prospectively and in 12 patients PML lesions
       were identified retrospectively. MRI sequences were analysed for
       PML lesion distribution, appearance, grey matter/white matter
       involvement and possible signs of inflammation. Lesion
       probability maps were created to demonstrate lesion distribution
       pattern.
       >
       > RESULTS:
       >
       > The frontal lobe was involved in 14 patients (77.8%) and the
       parietal lobe in 4 patients (22.2%). Most patients presented
       with focal lesions (13 patients, 72.2%) involving one single
       lobe (12 patients, 66.7%). The cortical grey matter was affected
       in 15 patients (83.3%) and 13 patients (72.2%) presented with a
       combination of cortical grey and white matter involvement. Signs
       of inflammation were detected in 7 patients (38.8%). Among
       patients with available diffusion-weighted imaging, 6 patients
       (40%) did not show high-signal-intensity lesions. A classical
       imaging pattern including unilateral and unilobar focal lesions
       in the frontal lobe affecting the cortical grey matter or the
       cortical grey and adjacent white matter was observed in 8
       patients (44.4%).
       >
       > CONCLUSIONS:
       >
       > Asymptomatic natalizumab-associated PML manifestations on MRI
       show a rather localised disease, frequently located in the
       frontal lobes, affecting the cortical grey matter and adjacent
       juxtacortical white matter. Awareness of this lesion pattern
       facilitates an earlier diagnosis of natalizumab-associated PML
       in an asymptomatic stage associated with a more favourable
       prognosis.
       >
       --- End Quote ---
       The abstract can be seen here
  HTML http://www.ncbi.nlm.nih.gov/pubmed/25205744.
       *****************************************************
       Page 1 of 1