Evidence map›Paper›PMID 32243459›Full record

ArticlePloS one2020

Number of MRI T1-hypointensity corrected by T2/FLAIR lesion volume indicates clinical severity in patients with multiple sclerosis.

Tetsuya Akaishi, Toshiyuki Takahashi, Kazuo Fujihara, Tatsuro Misu, Shunji Mugikura, Michiaki Abe, Tadashi Ishii, Masashi Aoki, Ichiro Nakashima

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 12 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Tetsuya AkaishiDepartment of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.ORCID 0000-0001-6728-4966
Toshiyuki TakahashiDepartment of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Kazuo FujiharaDepartment of Multiple Sclerosis Therapeutics, Fukushima Medical University School of Medicine, Fukushima, Japan.
Tatsuro MisuDepartment of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Shunji MugikuraDepartment of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Michiaki AbeDepartment of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.
Tadashi IshiiDepartment of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.
Masashi AokiDepartment of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Ichiro NakashimaDepartment of Neurology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Tohoku University · JPTohoku University Hospital · JPFukushima Medical University · JPTohoku Medical and Pharmaceutical University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionProgressive brain atrophy, development of T1-hypointense areas, and T2-fluid-attenuated inversion recovery (FLAIR)-hyperintense lesion formation in multiple sclerosis (MS) are popular volumetric data that are often utilized as clinical outcomes. However, the exact clinical interpretation of these volumetric data has not yet been fully established.

methodsWe enrolled 42 consecutive patients with MS who fulfilled the revised McDonald criteria of 2010. They were followed-up for more than 3 years from onset, and cross-sectional brain volumetry was performed. Patients with no brain lesions were excluded in advance from this study. For the brain volumetric data, we evaluated several parameters including age-adjusted gray-matter volume atrophy, age-adjusted white-matter volume atrophy, and T2-FLAIR lesion volume. The numbers of T1-hypointense and T2-FLAIR-hyperintense areas were also measured along the same timeline. The clinical data pertaining to disease duration, expanded disability status scale (EDSS), and MS severity score (MSSS) at the timing of volumetry were collected.

resultsAmong the 42 patients with MS and brain lesions, the number of T1-hypointensity (rho = 0.51, p<0.001), gray-matter atrophy (rho = 0.40, p<0.01) and white-matter atrophy (rho = 0.49, p<0.001) correlated with the EDSS. T1-hypointensity count divided by FLAIR lesion volume correlated with the MSSS (rho = 0.60, p<0.001). Meanwhile, counts or volumes of FLAIR-hyperintense lesions were associated only with the times of past relapses, and did not correlate with present neurological disability level or ongoing disease activity. These findings were consistent regardless of the presence of spinal cord lesions.

conclusionNumbers of T1-hypointensities and brain atrophy equally indicated the current neurological disability in MS. The number of T1-hypointensities divided by FLAIR lesion volume represented the clinical severity. The size or number of FLAIR lesions reflected earlier relapses but was not a good indicator of neurological disability or clinical severity.

Indexed as

AdolescentAdultAtrophyBrainBrain MappingFemaleGray MatterHumansMagnetic Resonance ImagingMaleMultiple SclerosisRegression AnalysisYoung Adult

Identifiers

PMID32243459
PMCPMC7122737
OpenAlexW3014978504

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.