Correlation between the corpus callosum index and brain atrophy, lesion load, and cognitive dysfunction in multiple sclerosis.

BACKGROUND: The corpus callosum index (CCI) can be easily and reliably obtained from conventional magnetic resonance imaging (MRI) and has been proposed as a possible marker of brain atrophy in MS. However, further validation of its correlation with volumetric measurements is still warranted. OBJECTIVE: To assess the correlation of the CCI with the corpus callosum volume (CCV), brain and lesion volumes, and level of disability in MS. METHODS: Cross-sectional, exploratory study including patients with relapsing-remitting MS. Clinical assessment comprised of physical and cognitive disability scales. MRI parameters included conventional volumetric measurements, the CCI (manual), and the CCV (automated). RESULTS: Twenty-four patients were included. There was a strong correlation between the CCI and CCV. The CCI correlated strongly with the white matter and lesion volumes, and moderately with the whole brain volume and scores on the Paced Auditory Serial Addition Test and MS Functional Composite. There were no correlations between the CCI and either gray matter volume or scores on the Expanded Disability Status Scale, the 9-Hole Peg Test, or the Timed 25-Foot Walk test. CONCLUSION: The findings support the validity of the CCI as an easy-to-obtain marker of brain atrophy, lesion load, and cognitive dysfunction in patients with MS.

Oral disease-modifying therapies for multiple sclerosis.

Classical multiple sclerosis (MS) treatments using first-line injectable drugs, although widely applied, remain a major concern in terms of therapeutic adherence and efficacy. New oral drugs recently approved for MS treatment represent significant advances in therapy. The oral route of administration clearly promotes patient satisfaction and increases therapeutic compliance. However, these drugs may also have safety and tolerability issues, and a thorough analysis of the risks and benefits is required. Three oral drugs have been approved by regulatory agencies for MS treatment: fingolimod, teriflunomide, and dimethyl fumarate. This article reviews the mechanisms of action, safety, and efficacy of these drugs and two other drugs that have yielded positive results in phase III trials: cladribine and laquinimod.

The onset location of neuromyelitis optica spectrum disorder predicts the location of subsequent relapses.

We evaluated whether the location of the initial attack predicted the locations of subsequent events in neuromyelitis optica spectrum disorder (NMOSD). In the retrospective analysis from 164 patients with NMOSD, increased odds of a second attack occurring in the initial event location were seen in all locations (odds ratio [OR] brain: 16.00; brainstem: 4.42; optic nerve: 4.08; and spinal cord: 4.59), as was a positive linear trend when evaluating the number of previous events in the same location as the third event location (OR brain: 62.52; brainstem: 44.55; optic nerve: 6.48; and spinal cord: 2.98). This study suggests early clinical events of NMOSD tend to recur in the same anatomical location within the central nervous system (CNS).