ArticleAnnals of neurology2014
Hyperintense cortical signal on magnetic resonance imaging reflects focal leukocortical encephalitis and seizure risk in progressive multifocal leukoencephalopathy.
Article in Annals of neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 35 citations in OpenAlex.
- Overview of MRI findings in progressive multifocal leukoencephalopathy.Japanese journal of radiology · 2025Review
- The neuroradiology of progressive multifocal leukoencephalopathy: a clinical trial perspective.Brain : a journal of neurology · 2022Review
- Acute seizure risk in patients with encephalitis: development and validation of clinical prediction models from two independent prospective multicentre cohorts.BMJ neurology open · 2022Article
- MRI imaging features of HIV-related central nervous system diseases: diagnosis by pattern recognition in daily practice.Japanese journal of radiology · 2021Review
- Susceptibility-Weighted MR Imaging Hypointense Rim in Progressive Multifocal Leukoencephalopathy: The End Point of Neuroinflammation and a Potential Outcome Predictor.AJNR. American journal of neuroradiology · 2019Article
- Delayed appearance of transient hyperintensity foci on T1-weighted magnetic resonance imaging in acute disseminated encephalomyelitis.Japanese journal of radiology · 2019Article
- Progressive Multifocal Leukoencephalopathy: Current Insights.Degenerative neurological and neuromuscular disease · 2019Review
- Progressive Multifocal Leukoencephalopathy in HIV-Uninfected Individuals.Current infectious disease reports · 2016Review
- Drug-associated progressive multifocal leukoencephalopathy: a clinical, radiological, and cerebrospinal fluid analysis of 326 cases.Journal of neurology · 2016Article
- Predictors and characteristics of seizures in survivors of progressive multifocal leukoencephalopathy.Journal of neurovirology · 2016Article
- Progressive neurologic dysfunction in a psoriasis patient treated with dimethyl fumarate.Annals of neurology · 2015Review
- Lack of Major Histocompatibility Complex Class I Upregulation and Restrictive Infection by JC Virus Hamper Detection of Neurons by T Lymphocytes in the Central Nervous System.Journal of neuropathology and experimental neurology · 2015Article
- Novel syndromes associated with JC virus infection of neurons and meningeal cells: no longer a gray area.Current opinion in neurology · 2015Review
- Neurological immune reconstitution inflammatory response: riding the tide of immune recovery.Current opinion in neurology · 2015Review
- Progressive Multifocal Leukoencephalopathy.F1000Research · 2015Review
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo determine the frequency of hyperintense cortical signal (HCS) on T1-weighted precontrast magnetic resonance (MR) images in progressive multifocal leukoencephalopathy (PML) patients, its association with seizure risk and immune reconstitution inflammatory syndrome (IRIS), and its pathologic correlate.
methodsWe reviewed clinical data including seizure history, presence of IRIS, and MR imaging scans from PML patients evaluated at our institution between 2003 and 2012. Cases that were diagnosed either using cerebrospinal fluid JC virus (JCV) polymerase chain reaction, brain biopsy, or autopsy, and who had MR images available were included in the analysis (n=49). We characterized pathologic findings in areas of the brain that displayed HCS in 2 patients and compared them with isointense cortex in the same individuals.
resultsOf 49 patients, 17 (34.7%) had seizures and 30 (61.2%) had HCS adjacent to subcortical PML lesions on MR images. Of the 17 PML patients with seizures, 15 (88.2%) had HCS compared with 15 of 32 (46.9%) patients without seizures (p=0.006). HCS was associated with seizure development with a relative risk of 4.75 (95% confidence interval=1.2-18.5, p=0.006). Of the 20 patients with IRIS, 16 (80.0%) had HCS compared with 14 of 29 (49.3%) patients without IRIS (p=0.04). On histological examination, HCS areas were associated with striking JCV-associated demyelination of cortical and subcortical U fibers, significant macrophage infiltration, and a pronounced reactive gliosis in the deep cortical layers.
interpretationSeizures are a frequent complication in PML. HCS is associated with seizures and IRIS, and correlates histologically with JCV focal leukocortical encephalitis.
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