ArticleEuropean journal of neurology2021
A model for interrogating the clinico-radiological paradox in multiple sclerosis: Internuclear ophthalmoplegia.
Article in European journal of neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 12 citations in OpenAlex.
- MRI Markers of EDSS ≥ 3 in Relapsing-Remitting Multiple Sclerosis: An Assessment of Lesion Burden, Brain Volumetry, and IVIM-DWI Metrics.Brain sciences · 2026Article
- Virtual reality-based oculography detects internuclear ophthalmoplegia in multiple sclerosis and other neurological disorders.Journal of neurology · 2026Article
- Advances in ocular motor and pupil biomarkers for neurological disorders.Brain communications · 2026Review
- IVIM-DWI-Based Radiomics for Lesion Phenotyping and Clinical Status Prediction in Relapsing-Remitting Multiple Sclerosis.Journal of clinical medicine · 2025Article
- Ultra-High Contrast (UHC) MRI of the Brain, Spinal Cord and Optic Nerves in Multiple Sclerosis Using Directly Acquired and Synthetic Bipolar Filter (BLAIR) Images.Diagnostics (Basel, Switzerland) · 2025Review
- The virtual multiple sclerosis patient.iScience · 2024Article
- Clinical-Radiological Mismatch in Multiple Sclerosis Patients during Acute Relapse: Discrepancy between Clinical Symptoms and Active, Topographically Fitting MRI Lesions.Journal of clinical medicine · 2023Article
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeThe clinico-radiological paradox in multiple sclerosis (MS) is well recognized, relevant and yet poorly understood. The suitability of an in vivo model for the clinico-radiological paradox was tested, using internuclear ophthalmoplegia (INO) and the medial longitudinal fasciculus (MLF).
methodsIn this cross-sectional study lesions of the MLF were rated by an experienced MS neuroradiologist blinded to all other information. The presence of an INO was objectively determined by a validated infrared oculography protocol (DEMoNS). Clinical information, including the National Eye Institute Visual Function Questionnaire, was obtained.
resultsThis study included 202 patients with MS. The clinico-radiological paradox occurred in 50 patients (25%). This consisted of 45 patients having an INO without an MLF lesion and five patients with an MLF lesion but without an INO. The visual function overall score was related to the presence of an INO (p = 0.016), but not to MLF lesions seen on magnetic resonance imaging (MRI) (p = 0.207). A consensus list of potential causes for the clinico-radiological paradox was compiled and the MRI images were deposited in a repository.
conclusionThis study provides an objective and quantitative model to investigate the clinico-radiological paradox. Our data suggest that pathology of the MLF is more frequently detected and more clinically relevant by infrared oculography than by MLF lesion rating on MRI.
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