This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Its Correlation With Clinical Parameters, Evoked Potentials, and Intra-Blood-Brain Barrier IgG Synthesis

Robert W. Baumhefner, MD; Wallace W. Tourtellotte, MD, PhD; Karl Syndulko, PhD; Victor Waluch, MD, PhD; George W. Ellison, MD; Lawrence W. Meyers, MD; Stanley N. Cohen, MD; Meredith Osborne; Paul Shapshak, PhD

Arch Neurol. 1990;47(1):19-26.

Abstract
• Magnetic resonance imaging (MRI) of the cerebrum, cerebellum, brain stem, and upper cervical cord was performed in 62 individuals with clinically definite chronic, progressive multiple sclerosis (MS). The total area of MRI-demonstrated lesions was measured from film enlargements for each region using an interactive image analysis system. While the MRI was abnormal in 60 (97%) of 62 patients, the visual-evoked potentials in 51 (85%) of 60 patients, the brain stem auditory-evoked potentials (BAEPs) in 24(46%) of 52 patients, and the somatosensory-evoked potentials (SSEPs) in 45 (89%) of 54 patients, an abnormal intra-blood-brain barrier (BBB) IgG synthesis rate, IgG oligoclonal bands, or both were found in all 62 patients. The total area of MRI abnormality in the cerebrum was significantly correlated only with the intra-BBB IgG synthesis rate, abnormal visual-evoked potentials, impaired performance on the Symbol Digit Modalities Test (SDMT), and one test of standing duration in the quantitative examination of neurologic function (QENF). The brain stem lesion area correlated with the Kurtzke expanded disability status scale and brain stem functional systems score, the ambulation index, abnormal BAEPs, and impaired performance on the SDMT as well as multiple tests of upper and lower extremity function in the QENF. The cerebellar lesion area correlated with impaired performance on the SDMT and primarily upper extremity testing in the QENF. Factor analysis of the data showed that the major plaque burden in the cerebrum of patients with MS as demonstrated on the MRI had a strong relationship with neuropsychological functioning (SDMT) and the intra-BBB IgG synthesis rate, while most clinical assessments in MS seemed to be related primarily to noncerebral plaques in the brain stem and cerebellum. We conclude that the intra-BBB IgG synthesis rate, neuropsychological functioning, and cerebral MRI abnormalities should be investigated further as possible objective outcome measurements in future clinical treatment trials of MS.

Author Affiliations
From the Neurology and Research Services, Veterans Administration West Los Angeles Medical Center, Wadsworth Division (Drs Baumhefner, Tourtellotte, Syndulko, and Shapshak and Ms Osborne), Department of Neurology, UCLA School of Medicine, Reed Neurological Research Center (Drs Baumhefner, Tourtellotte, Syndulko, Ellison, Myers, Cohen, and Shapshak), and St Vincent's Hospital (Dr Waluch), Los Angeles, Calif.

Footnotes
Accepted for publication May 1, 1989.

Reprint requests to Neurology Service (W127A), VA Medical Center West Los Angeles, Wilshire & Sawtelle boulevards, Los Angeles, CA 90073 (Dr Baumhefner).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Posterior fossa lesion volume and slowed information processing in multiple sclerosis
Archibald et al.
Brain 2004;127:1526-1534.
ABSTRACT | FULL TEXT  

A Longitudinal Study of Callosal Atrophy and Interhemispheric Dysfunction in Relapsing-Remitting Multiple Sclerosis
Pelletier et al.
Arch Neurol 2001;58:105-111.
ABSTRACT | FULL TEXT  

Relapsing-Remitting Multiple Sclerosis: Longitudinal Analysis of MR Images-Lack of Correlation between Changes in T2 Lesion Volume and Clinical Findings
Miki et al.
Radiology 1999;213:395-399.
ABSTRACT | FULL TEXT  

MR Imaging Quantitation of Gray Matter Involvement in Multiple Sclerosis and Its Correlation with Disability Measures and Neurocognitive Testing
Catalaa et al.
Am. J. Neuroradiol. 1999;20:1613-1618.
ABSTRACT | FULL TEXT  

Olfactory dysfunction in multiple sclerosis: Relation to longitudinal changes in plaque numbers in central olfactory structures
Doty et al.
Neurology 1999;53:880-880.
ABSTRACT | FULL TEXT  

Characterization of White Matter Lesions in Multiple Sclerosis and Traumatic Brain Injury as Revealed by Magnetization Transfer Contour Plots
Bagley et al.
Am. J. Neuroradiol. 1999;20:977-981.
ABSTRACT | FULL TEXT  

Three dimensional MRI estimates of brain and spinal cord atrophy in multiple sclerosis
Liu et al.
J. Neurol. Neurosurg. Psychiatry 1999;66:323-330.
ABSTRACT | FULL TEXT  

Infratentorial atrophy on magnetic resonance imaging and disability in multiple sclerosis
Edwards et al.
Brain 1999;122:291-301.
ABSTRACT | FULL TEXT  

The Use of Brain Magnetic Resonance Imaging in Multiple Sclerosis
Goodkin et al.
Arch Neurol 1994;51:505-516.
ABSTRACT  

Functional and Magnetic Resonance Imaging Correlates of Callosal Involvement in Multiple Sclerosis
Pelletier et al.
Arch Neurol 1993;50:1077-1082.
ABSTRACT  

Magnetic Resonance Imaging (MRI) As an Outcome Measure in Multiple Sclerosis
Paty et al.
Neurorehabil Neural Repair 1993;7:117-129.
 

Neuroperformance Evaluation of Multiple Sclerosis Disease Progression in a Clinical Trial: Implications for Neurological Outcomes
Syndulko et al.
Neurorehabil Neural Repair 1993;7:153-176.
 

The Value of Brain Magnetic Resonance Imaging in Multiple Sclerosis
Rudick
Arch Neurol 1992;49:685-686.
ABSTRACT  

Neuropsychological Correlates of White-Matter Lesions in Healthy Elderly Subjects: A Threshold Effect
Boone et al.
Arch Neurol 1992;49:549-554.
ABSTRACT  

A Commentary on Correlates Between Cerebrospinal Fluid {gamma}-Globulins and Magnetic Resonance Imaging in Multiple Sclerosis
Baumhefner et al.
Arch Neurol 1990;47:841-842.
ABSTRACT