Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1989 Jan;52(1):14–17. doi: 10.1136/jnnp.52.1.14

Quantitative magnetic resonance imaging in multiple sclerosis: the effect of high dose intravenous methylprednisolone.

J Kesselring 1, D H Miller 1, D G MacManus 1, G Johnson 1, N M Milligan 1, N Scolding 1, D A Compston 1, W I McDonald 1
PMCID: PMC1032649  PMID: 2709033

Abstract

Magnetic resonance imaging was performed on 50 patients with clinically definite or probable multiple sclerosis before and 15 days after starting treatment with intravenous methylprednisolone (0.5 g daily for 5 days). Scans were abnormal in 49 patients. New lesions had appeared on the second scan in nine individuals and in seven a single pre-existing lesion appeared to have become smaller but in no case were lesions seen to disappear. Two patients showed both reduction in the size of an abnormal area and development of a single new lesion indicating that corticosteroids do not appear rapidly to alter the process underlying plaque formation. Measurements of relaxation times were performed in 12 randomly selected patients. All showed elevated values in normal appearing white matter but not cortex before treatment compared with 18 healthy controls. After treatment a significant decrease of T1 and T2 was observed in cortex, and of T1 alone in normal appearing white matter. No significant change could be detected within lesions, a finding attributed to the wide range of relaxation values observed at these sites before treatment. Since brain water content is increased in normal appearing white matter of multiple sclerosis patients, and is significantly reduced by high-dose methylprednisolone, resolution of oedema may contribute to the rapid spontaneous or corticosteroid induced symptomatic recovery that characterises the disease in its early stages.

Full text

PDF
14

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allen I. V., McKeown S. R. A histological, histochemical and biochemical study of the macroscopically normal white matter in multiple sclerosis. J Neurol Sci. 1979 Mar;41(1):81–91. doi: 10.1016/0022-510x(79)90142-4. [DOI] [PubMed] [Google Scholar]
  2. Barnes D., McDonald W. I., Landon D. N., Johnson G. The characterization of experimental gliosis by quantitative nuclear magnetic resonance imaging. Brain. 1988 Feb;111(Pt 1):83–94. doi: 10.1093/brain/111.1.83. [DOI] [PubMed] [Google Scholar]
  3. Barnes M. P., Bateman D. E., Cleland P. G., Dick D. J., Walls T. J., Newman P. K., Saunders M., Tilley P. J. Intravenous methylprednisolone for multiple sclerosis in relapse. J Neurol Neurosurg Psychiatry. 1985 Feb;48(2):157–159. doi: 10.1136/jnnp.48.2.157. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Compston D. A., Milligan N. M., Hughes P. J., Gibbs J., McBroom V., Morgan B. P., Campbell A. K. A double-blind controlled trial of high dose methylprednisolone in patients with multiple sclerosis: 2. Laboratory results. J Neurol Neurosurg Psychiatry. 1987 May;50(5):517–522. doi: 10.1136/jnnp.50.5.517. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dowling P. C., Bosch V. V., Cook S. D. Possible beneficial effect of high-dose intravenous steroid therapy in acute demyelinating disease and transverse myelitis. Neurology. 1980 Jul;30(7 Pt 2):33–36. doi: 10.1212/wnl.30.7_part_2.33. [DOI] [PubMed] [Google Scholar]
  6. Halliday A. M., McDonald W. I. Pathophysiology of demyelinating disease. Br Med Bull. 1977 Jan;33(1):21–27. doi: 10.1093/oxfordjournals.bmb.a071390. [DOI] [PubMed] [Google Scholar]
  7. Jacobson S. G., Eames R. A., McDonald W. I. Optic nerve fibre lesions in adult cats: pattern of recovery of spatial vision. Exp Brain Res. 1979 Aug 1;36(3):491–508. doi: 10.1007/BF00238518. [DOI] [PubMed] [Google Scholar]
  8. Johnson G., Ormerod I. E., Barnes D., Tofts P. S., MacManus D. Accuracy and precision in the measurement of relaxation times from nuclear magnetic resonance images. Br J Radiol. 1987 Feb;60(710):143–153. doi: 10.1259/0007-1285-60-710-143. [DOI] [PubMed] [Google Scholar]
  9. Kurtzke J. F. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983 Nov;33(11):1444–1452. doi: 10.1212/wnl.33.11.1444. [DOI] [PubMed] [Google Scholar]
  10. Lacomis D., Osbakken M., Gross G. Spin-lattice relaxation (T1) times of cerebral white matter in multiple sclerosis. Magn Reson Med. 1986 Apr;3(2):194–202. doi: 10.1002/mrm.1910030203. [DOI] [PubMed] [Google Scholar]
  11. Lagenstein I., Willig R. P., Kühne D. Cranial computed tomography (CCT) findings in children treated with ACTH and dexamethasone: first results. Neuropadiatrie. 1979 Nov;10(4):370–384. doi: 10.1055/s-0028-1085339. [DOI] [PubMed] [Google Scholar]
  12. Larsson H. B., Frederiksen J., Kjaer L., Henriksen O., Olesen J. In vivo determination of T1 and T2 in the brain of patients with severe but stable multiple sclerosis. Magn Reson Med. 1988 May;7(1):43–55. doi: 10.1002/mrm.1910070106. [DOI] [PubMed] [Google Scholar]
  13. Lodder J., de Weerd A. W., Koetsier J. C., van der Lugt P. J. Computed tomography in acute cerebral multiple sclerosis. A report of two cases. Arch Neurol. 1983 May;40(5):320–322. doi: 10.1001/archneur.1983.04050050088015. [DOI] [PubMed] [Google Scholar]
  14. Mathur-De Vré R. Biomedical implications of the relaxation behaviour of water related to NMR imaging. Br J Radiol. 1984 Nov;57(683):955–976. doi: 10.1259/0007-1285-57-683-955. [DOI] [PubMed] [Google Scholar]
  15. McDonald W. I. The mystery of the origin of multiple sclerosis. J Neurol Neurosurg Psychiatry. 1986 Feb;49(2):113–123. doi: 10.1136/jnnp.49.2.113. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Ormerod I. E., Miller D. H., McDonald W. I., du Boulay E. P., Rudge P., Kendall B. E., Moseley I. F., Johnson G., Tofts P. S., Halliday A. M. The role of NMR imaging in the assessment of multiple sclerosis and isolated neurological lesions. A quantitative study. Brain. 1987 Dec;110(Pt 6):1579–1616. doi: 10.1093/brain/110.6.1579. [DOI] [PubMed] [Google Scholar]
  17. Poser C. M., Paty D. W., Scheinberg L., McDonald W. I., Davis F. A., Ebers G. C., Johnson K. P., Sibley W. A., Silberberg D. H., Tourtellotte W. W. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol. 1983 Mar;13(3):227–231. doi: 10.1002/ana.410130302. [DOI] [PubMed] [Google Scholar]
  18. Rose A. S., Kuzma J. W., Kurtzke J. F., Namerow N. S., Sibley W. A., Tourtellotte W. W. Cooperative study in the evaluation of therapy in multiple sclerosis. ACTH vs. placebo--final report. Neurology. 1970 May;20(5):1–59. doi: 10.1212/wnl.20.5_part_2.1. [DOI] [PubMed] [Google Scholar]
  19. Tourtellotte W. W., Parker J. A. Some spaces and barriers in postmortem multiple sclerosis. Prog Brain Res. 1968;29:493–525. doi: 10.1016/S0079-6123(08)64178-3. [DOI] [PubMed] [Google Scholar]
  20. Triarhou L. C., Herndon R. M. The effect of dexamethasone on L-alpha-lysophosphatidyl choline (lysolecithin)-induced demyelination of the rat spinal cord. Arch Neurol. 1986 Feb;43(2):121–125. doi: 10.1001/archneur.1986.00520020015008. [DOI] [PubMed] [Google Scholar]
  21. Troiano R., Hafstein M., Ruderman M., Dowling P., Cook S. Effect of high-dose intravenous steroid administration on contrast-enhancing computed tomographic scan lesions in multiple sclerosis. Ann Neurol. 1984 Mar;15(3):257–263. doi: 10.1002/ana.410150309. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES