The role of pontine lesion location in differentiating multiple sclerosis from vascular risk factor-related small vessel disease. (May 2021)

• Record Type: Journal Article
• Authors: Geraldes, Ruth; Juryńczyk, Maciej; dos Passos, Giordani Rodrigues; Pichler, Alexander; Chung, Karen; Hagens, Marloes; Ruggieri, Serena; Auger, Cristina; Sastre-Garriga, Jaume; Enzinger, Christian; Chard, Declan; Barkhof, Frederik; Gasperini, Claudio; Rovira, Alex; DeLuca, Gabriele; Palace, Jacqueline
• Is Part Of: Multiple sclerosis. Volume 27:Number 6(2021)
• Page Start: 968
• Page End: 972
• Publication Date: 2021-05
• Subjects: Multiple sclerosis -- cerebral small vessel disease -- imaging -- differential diagnosis; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/1352458520943777
• Languages: English
• ISSNs: 1352-4585

Abstract

Background: Differentiating multiple sclerosis (MS) from vascular risk factor (VRF)-small vessel disease (SVD) can be challenging. Objective and Methods: In order to determine whether or not pontine lesion location is a useful discriminator of MS and VRF-SVD, we classified pontine lesions on brain magnetic resonance imaging (MRI) as central or peripheral in 93 MS cases without VRF, 108 MS patients with VRF and 43 non-MS cases with VRF. Results: MS without VRF were more likely to have peripheral pons lesions (31.2%, 29/93) than non-MS with VRF (0%, 0/43) (Exp( B ) = 29.8; 95% confidence interval (CI) = (1.98, 448.3); p = 0.014) but there were no significant differences regarding central pons lesions between MS without VRF (5.4%, 5/93) and non-MS with VRF patients (16.3%, 7/43) (Exp( B ) = 0.89; 95% CI = (0.2, 3.94); p = 0.87). The presence of peripheral pons lesions discriminated between MS and VRF-SVD with 100% (95% CI = (91.8, 100)) specificity. The proportion of peripheral pons lesions in MS with VRF (30.5%, 33/108) was similar to that seen in MS without VRF (31.2%, 29/93, p = 0.99). Central lesions occurred in similar frequency in MS with VRF (8.3%, 9/108) and non-MS with VRF (16.3%, 7/43, p = 0.15). Conclusion: Peripheral pons lesion location is a good discriminator of MS from vascular lesions.