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Persistently Gadolinium-Enhancing Lesion Is a Predictor of Poor Prognosis in NMOSD Attack: a Clinical Trial
- Source :
- Neurotherapeutics
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Gadolinium (Gd)-contrast MRI for reliable detection of blood–brain barrier (BBB) breakdown is widely used in neuromyelitis optica spectrum disorder (NMOSD) attack. Nonetheless, little is known about the predictive role of gadolinium-enhancing lesion in prognosis of NMOSD attack. The aim of this work is to investigate the predictive value of persistently Gd-enhanced lesions to medium-term outcome after attack. Data for this analysis came from an ongoing prospective cohort study (CLUE). NMOSD patients with acute attack were enrolled from January 2019 to March 2020. All patients underwent Gd-contrast MRI at baseline and 1 month, and disability was assessed by Expanded Disability Status Scale (EDSS). Primary outcome was EDSS improvement from baseline to month 6. Multiple logistic regression identified predictors for poor recovery of NMOSD attack. Forty-one participants were analyzed, of which 21 patients had persistently Gd-enhancing lesions. Patients in no enhancement (NE) group showed a significant shift in 6-month EDSS distributions compared with those in persistent enhancement (PE) group (p = 0.005). Poor recovery rate of the PE group was higher than that of the NE group at 6 months (p = 0.033). In patients with aquaporin-4-positive, first-attack, transverse myelitis or in a high-dose steroid treatment subgroup, the improvement of EDSS scores in the PE group was still less compared with that in the NE group (p
- Subjects :
- Adult
Male
0301 basic medicine
China
medicine.medical_specialty
Neurology
Gadolinium
Methylprednisolone
Transverse myelitis
Lesion
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Internal medicine
Humans
Medicine
Pharmacology (medical)
Prospective Studies
Prospective cohort study
Pharmacology
Neuromyelitis optica
Expanded Disability Status Scale
business.industry
Neuromyelitis Optica
Middle Aged
Prognosis
medicine.disease
Gadolinium-Enhancing Lesion
Magnetic Resonance Imaging
Clinical trial
Neuroprotective Agents
030104 developmental biology
Female
Original Article
Neurology (clinical)
medicine.symptom
business
Biomarkers
030217 neurology & neurosurgery
Follow-Up Studies
Subjects
Details
- ISSN :
- 18787479, 19337213, and 04106830
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- Neurotherapeutics
- Accession number :
- edsair.doi.dedup.....a318a5532aabc9024e85fa327b59be4a