ArticleNeurology2012
Metabolic profile of PML lesions in patients with and without IRIS: an observational study.
Article in Neurology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 46 citations in OpenAlex.
- Review
- Overview of MRI findings in progressive multifocal leukoencephalopathy.Japanese journal of radiology · 2025Review
- JC Polyomavirus Infection: A Narrative Review.Infectious diseases and therapy · 2025Review
- Magnetic resonance spectroscopy for discriminating primary angiitis of the central nervous system from gliomas and lymphomas.Acta neurologica Belgica · 2025Article
- John Cunningham Virus and Progressive Multifocal Leukoencephalopathy: A Falsely Played Diagnosis.Diseases (Basel, Switzerland) · 2024Review
- Progressive Multifocal Leukoencephalopathy Treated by Immune Checkpoint Inhibitors.Annals of neurology · 2023Article
- The neuroradiology of progressive multifocal leukoencephalopathy: a clinical trial perspective.Brain : a journal of neurology · 2022Review
- Progressive multifocal leukoencephalopathy and the spectrum of JC virus-related disease.Nature reviews. Neurology · 2021Review
- Human Immunodeficiency Virus in the Brain-Culprit or Facilitator?Infectious diseases · 2018Review
- A prominent lactate peak as a potential key magnetic resonance spectroscopy (MRS) feature of progressive multifocal leukoencephalopathy (PML): Spectrum pattern observed in three patients.Bosnian journal of basic medical sciences · 2017Article
- PML-IRIS in an HIV-2-infected patient presenting as Bell's palsy.Journal of neurovirology · 2017Article
- Current and Emerging Therapies in Multiple Sclerosis: Implications for the Radiologist, Part 2-Surveillance for Treatment Complications and Disease Progression.AJNR. American journal of neuroradiology · 2017Review
- Article
- Immune Reconstitution Inflammatory Syndrome Unmasking or Worsening AIDS-Related Progressive Multifocal Leukoencephalopathy: A Literature Review.Frontiers in immunology · 2017Review
- Insight into MetabolicFrontiers in neurology · 2017Article
- Treatment of Progressive Multifocal Leukoencephalopathy With Mirtazapine.Clinical drug investigation · 2016Review
- Predictors and characteristics of seizures in survivors of progressive multifocal leukoencephalopathy.Journal of neurovirology · 2016Article
- Interleukin-7 treatment of PML in a patient with idiopathic lymphocytopenia.Neurology(R) neuroimmunology & neuroinflammation · 2016Article
- Progressive neurologic dysfunction in a psoriasis patient treated with dimethyl fumarate.Annals of neurology · 2015Review
- Neurological immune reconstitution inflammatory response: riding the tide of immune recovery.Current opinion in neurology · 2015Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo characterize progressive multifocal leukoencephalopathy (PML) lesions by contrast-enhanced MRI and evaluate their metabolism using proton magnetic resonance spectroscopy ((1)H- MRS) in the setting of immune reconstitution inflammatory syndrome (IRIS).
methodsA total of 42 patients with PML underwent a clinical evaluation as well as brain MRI and (1)H-MRS at baseline and 3, 6, and 12 months later. The presence of IRIS was determined based on clinical and laboratory criteria. Ratios of N-acetylaspartate (NAA), choline (Cho), myo-inositol (mI), and lipid/lactate (Lip1 and Lip2) to creatine (Cr) were measured and correlated with the presence of contrast enhancement (CE) in PML lesions.
resultsIRIS occurred in 16 of 28 (57.1%) PML survivors (PML-S) and 1 of 14 (7.1%) PML progressors (PML-P). Lesions of patients with PML-IRIS showed significantly higher Cho/Cr (p = 0.0001), mI/Cr (p = 0.02), Lip1/Cr (p < 0.0001), and Lip2/Cr (p = 0.002) ratios and lower NAA/Cr (p = 0.02) ratios than patients with PML who did not have IRIS. An elevated Cho/Cr ratio was associated with CE within the (1)H-MRS voxel, whereas lipid/Cr ratios were elevated in PML-IRIS lesions independently of CE. Follow-up until 33 months from PML onset showed persistent elevation of the mI/Cr ratio in lesions of patients with PML-IRIS. A Lip1/Cr ratio greater than 1.5 combined with the presence of CE yielded a 79% probability of IRIS compared with 13% in the absence of these criteria.
conclusion(1)H-MRS is a valuable tool to recognize and track IRIS in PML and may prove useful in the clinical management of these patients.
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Registered trials
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