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. 2021 May;42(5):1959-1961.
doi: 10.1007/s10072-020-04764-0. Epub 2020 Sep 29.

Focal cortical atrophy following transient meningeal enhancement in a progressive multiple sclerosis

Mickael Bonnan  1 , Paul Money  2 , Pauline Desblache  2 , Raluca Marasescu  3 , Lise-Marlène Puvilland  3 , Stéphanie Demasles  3 , Camille Dahan  3 , Elsa Krim  3 , Alan Tucholka  4 , Senan Doyle  4 , Bruno Barroso  3
Affiliations

Focal cortical atrophy following transient meningeal enhancement in a progressive multiple sclerosis

Mickael Bonnan et al. Neurol Sci. 2021 May.

Abstract

Recent studies identified chronic leptomeningeal enhancement (LME) in late-acquired FLAIR sequences in secondary progressive (SP) multiple sclerosis (MS). These LMEs correlate with focal cortical inflammation and demyelination observed by pathology, which are supposed to drive long-term cortical atrophy. We report a spontaneously remitting meningeal uptake in a patient suffering from SP MS. No cortical lesion was visible on FLAIR or DIR sequences, but the rate of cortical atrophy was higher in this area. This case suggests that conventional 3-T MRI, by contrary to white matter lesions, may be amnesic with regard to the potential burden of previous regressive meningeal lesions. Moreover, T1-enhanced sequences underscore the real inflammatory activity. LME could be more than passive markers of SP MS, but is also directly responsible for focal cortical atrophy and could be an early manifestation of cortical lesions.

Keywords: Cortical atrophy; Leptomeningeal contrast enhancement; Multiple sclerosis; Relapse.

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References

    1. Absinta M, Vuolo L, Rao A, Nair G, Sati P, Cortese IC, Ohayon J, Fenton K, Reyes-Mantilla MI, Maric D, Calabresi PA, Butman JA, Pardo CA, Reich DS (2015) Gadolinium-based MRI characterization of leptomeningeal inflammation in multiple sclerosis. Neurology 85:18–28 - DOI
    1. Forbes F, Doyle S, Garcia-Lorenzo D, Barillot C, Dojat M (2010) A weighted multi-sequence Markov model for brain lesion segmentation. In: Thirteenth International Conference on Artificial Intelligence and Statistics (AISTATS).
    1. Granberg T, Fan Q, Treaba CA, Ouellette R, Herranz E, Mangeat G, Louapre C, Cohen-Adad J, Klawiter EC, Sloane JA, Mainero C (2017) In vivo characterization of cortical and white matter neuroaxonal pathology in early multiple sclerosis. Brain 140:2912–2926 - DOI
    1. Harrison DM, Wang KY, Fiol J, Naunton K, Royal W 3rd, Hua J, Izbudak I (2017) Leptomeningeal enhancement at 7T in multiple sclerosis: frequency, morphology, and relationship to cortical volume. J Neuroimaging 27:461–468 - DOI
    1. Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sorensen PS, Thompson AJ, Wolinsky JS, Balcer LJ, Banwell B, Barkhof F, Bebo B Jr, Calabresi PA, Clanet M, Comi G, Fox RJ, Freedman MS, Goodman AD, Inglese M, Kappos L, Kieseier BC, Lincoln JA, Lubetzki C, Miller AE, Montalban X, O'Connor PW, Petkau J, Pozzilli C, Rudick RA, Sormani MP, Stuve O, Waubant E, Polman CH (2014) Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology 83:278–286 - DOI

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