Keywords : multiple sclerosis


The Role of Gender in Early Onset Relapsing Remitting Multiple Sclerosis

Hasan Azeez Al-Hamadani

Iraqi Postgraduate Medical Journal, 2016, Volume 15, Issue 2, Pages 250-257

ABSTRACT:
BACKGROUND:
Multiple sclerosis is an autoimmune inflammatory demyelinating disorder of the central nervous system. Multiple sclerosis is now universally found to be more prevalent in women than men
OBJECTIVE:
The aim of the study is to clarify the role of gender in early onset multiple sclerosis
PATIENTS AND METHODS:
This retrospective study was conducted in the multiple sclerosis clinic archive system in the Medical City Hospital in Baghdad, Iraq. Data collection was carried out between March 2008 and March 2009. The patients diagnosed to have relapse remitting multiple sclerosis according to the revised McDonald’s diagnostic criteria for multiple sclerosis, and onset of disease must be before the eighteenth birthday. For each patient, the following information was gathered: age, gender, date of onset, and date of second attack, presenting symptom, and extended disability status scale and the date, and type and location of MRI lesions. A p-value <0.05 was considered the cutoff point to determine significant findings.
RESULTS:
Forty-eight of the patients where females (62.3%) and 29 patients where males (37.7%), with a female: male ratio 1.6:1.
No significant difference was found regarding distribution of gender in each age group, and no significant difference was found when age at onset was compared between males and females, although in male patients a shift to children and a shift at adolescence in female were observed
The comparison of different radiological sites between males and females shows a significant difference with more males having infratentorial lesions compared with females (P=0.033).
No significant difference was found between the two genders regarding, age at onset the presenting symptom, mode of onset and no significant difference was found when interval between the first and second attack was compared between males and females.
CONCLUSION:
Female preponderance was highest for subjects with disease onset at adolescents. No significant difference was found when age at onset was compared between males and females, although in male patients, a shift to children and a shift at adolescence in female were observed. A significant difference in the time, between first and second attack between males and females. A significant difference in the MRI findings was the finding that males had a higher incidence of infratentorial lesion than females.
KEY WORLDS: gender, multiple sclerosis.

The Role of Double Inversion Recovery Sequence in Detecting Gray Matter Lesions in patients with Multiple Sclerosis Using 3Tesla MRI

Mohssin Abd Ali Hussain; Behjet Abid Hani; Mohammed Abid Kadhim

Iraqi Postgraduate Medical Journal, 2016, Volume 15, Issue 1, Pages 19-27

ABSTRACT :
BACKGROUND:
In the recent time, the sequence used to delineate gray matter lesions is Double Inversion Recovery (DIR), with the use of this sequence in high magnetic field (3 Tesla machine).
OBJECTIVE:
To detect and localize gray matter lesions in patients with established multiple sclerosis using DIR sequence in 3 Tesla MRI. Also to compare the detection rate of white matter lesions by the use of DIR versus Fluid Attenuation Inversion Recovery (FLAIR) sequence.
PATIENTS AND METHODS:
A prospective study included 54 patients with established diagnosis of multiple sclerosis of more than 3 years duration was conducted from April 2014 to January 2015. The study was done in the MRI units of Al-Yarmouk Teaching Hospital and Al-Imamian Al-Kadhimian Medical City. All patients were examined with the following MRI imaging sequences: T2WI axial, T2 FLAIR sagittal and coronal, T1 axial and sagittal, DIR axial and coronal. T1 Sagittal and axial were repeated after giving IV contrast and examined after 30 minutes postcontrast. Gray matter lesions were classified according to Peterson and Bo model. Statistical analysis conducted by using Excel 2013 version.
RESULTS:
Fifty four patients with established diagnosis of MS (43 patients with relapsing remitting MS and 11 patients with secondary progressive MS) were included. Of the 54 patients, 39 patients (72.2%) patients have positive gray matter lesion. The 39 patients with positive gray matter lesions are classified as follows: 26 patients (66.5%) had sub-pial lesions, 9 patients (23%) had leucocortical lesions, 3 patients (7.5%) showed entirely cortical lesions, and finally the whole cortex is involved in 1 patient only (2.5%). The insular cortex was the most commonly involved region seen in 14 patients (35.8%), followed by the thalamic lesions. Among the 39 patients with positive 9 patients (16.5%) had additional deep nuclei lesions. Total number of lesions detected by DIR (320 lesions) was largely greater than the total number of lesions detected by FLAIR (185 lesions).
CONCLUSION:
DIR is a sensitive sequence for detection of gray matter lesion, DIR is more sensitive than FLAIR in detection of white matter lesions and cortical gray matter lesions are more commonly encountered than deep nuclei lesions.
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The Role of Gender in Early Onset Relapsing Remitting Multiple Sclerosis

Hasan Azeez Al-Hamadani

Iraqi Postgraduate Medical Journal, 2015, Volume 14, Issue 2, Pages 250-257

ABSTRACT:
BACKGROUND:
Multiple sclerosis is an autoimmune inflammatory demyelinating disorder of the central nervous system. Multiple sclerosis is now universally found to be more prevalent in women than men
OBJECTIVE:
The aim of the study is to clarify the role of gender in early onset multiple sclerosis
PATIENTS AND METHODS:
This retrospective study was conducted in the multiple sclerosis clinic archive system in the Medical City Hospital in Baghdad, Iraq. Data collection was carried out between March 2008 and March 2009. The patients diagnosed to have relapse remitting multiple sclerosis according to the revised McDonald’s diagnostic criteria for multiple sclerosis, and onset of disease must be before the eighteenth birthday. For each patient, the following information was gathered: age, gender, date of onset, and date of second attack, presenting symptom, and extended disability status scale and the date, and type and location of MRI lesions. A p-value <0.05 was considered the cutoff point to determine significant findings.
RESULTS:
Forty-eight of the patients where females (62.3%) and 29 patients where males (37.7%), with a female: male ratio 1.6:1.
No significant difference was found regarding distribution of gender in each age group, and no significant difference was found when age at onset was compared between males and females, although in male patients a shift to children and a shift at adolescence in female were observed
The comparison of different radiological sites between males and females shows a significant difference with more males having infratentorial lesions compared with females (P=0.033).
No significant difference was found between the two genders regarding, age at onset the presenting symptom, mode of onset and no significant difference was found when interval between the first and second attack was compared between males and females.
CONCLUSION:
Female preponderance was highest for subjects with disease onset at adolescents. No significant difference was found when age at onset was compared between males and females, although in male patients, a shift to children and a shift at adolescence in female were observed. A significant difference in the time, between first and second attack between males and females. A significant difference in the MRI findings was the finding that males had a higher incidence of infratentorial lesion than females.