Contributions
Abstract: EP1443
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Comorbidity
Background: Developmental venous anomalies (DVAs) are congenital malformations of veins that drain the brain parenchyma. Their incidence has been reported to be 2.58% by a previous autopsy study, while magnetic resonance imaging (MRI) based studies reported a frequency of up to 9.3% in the healthy population.
Objective: Our aim was to determine the prevalence of DVAs in patients with clinically isolated syndrome (CIS) and early multiple sclerosis (MS) and to assess, whether DVAs are related to altered clinical, MRI and laboratory measures.
Methods: All 93 patients (39 CIS, 54 MS) underwent routine neurological- and MRI examination in a single center. DVAs were identified by two raters on post-contrast T1 weighted images. In addition, conventional measures such as clinical disability (n=93) and T2 lesion load (n=90), brain atrophy (n=89), as well as cerebrospinal fluid (CSF) parameters (n=< 82) were determined.
Results: 29 DVAs were detected in 25 patients (25/93; 26.9%); 10 out of 39 CIS patients and 15 out 54 MS patients had DVAs. The prevalence of DVAs did not differ between CIS and MS (p=0.819). In the total cohort of patients, clinical, MRI and laboratory parameters did not differ significantly between patients with and without DVAs, with the exception that a higher frequency of hypointense lesions on fluid-attenuated inversion recovery (FLAIR) sequences in patients with DVAs has been found (percentage of hypointense FLAIR lesions in patients with vs. without DVAs: 44% vs. 28.3%; p=0.037). CIS patients with DVAs had significantly less total ventricle volume (p=0.030) at baseline and showed higher CSF-levels of albumin (p=0.004), immunoglobulin G (p=0.021) and immunoglobulin A (p=0.017). Nethertheless, DVAs were not associated with higher conversion rates from CIS to MS at 1-year (p=0.411) or 2-year follow-up (p=0.281), respectively.
Conclusion: We have detected DVAs in patients with CIS or early MS at a higher frequency than published before. The percentage of DVAs in CIS and MS patients was 10 times higher than the prevalence reported in the healthy population. Patients with DVAs did not have significantly altered clinical outcomes, brain atrophy rates and disease progression. Accordingly, CIS Patients with DVAs do not seem to be at higher risk for converting to MS.
Disclosure: Patrick Kruczek1, (patrick.kruczek@rub.de):
nothing to disclose
Barbara Bellenberg1, (barbara.bellenberg@rub.de):
BB received financial support by the German Federal Ministry for Education and
Research, BMBF, German Competence Network Multiple Sclerosis (KKNMS), grant no. 01GI1601I
Theodor Lutz1, (t.lutz@klinikum-bochum.de):
nothing to disclose
Ruth Schneider2, (ruth.schneider@rub.de):
nothing to disclose
Christian Ahlborn1, (christian.ahlborn@rub.de):
nothing to disclose
Ralf Gold2, (ralf.gold@rub.de):
RG received speaker's and board honoraria from Baxter, Bayer Schering, Biogen Idec, CLB Behring, Genzyme, Merck Serono, Novartis, Stendhal, Talecris, TEVA; his department received grant support from Bayer Schering, Biogen Idec, Genzyme, Merck Serono, Novartis, TEVA.
Odo Köster1, (odo.koester@rub.de):
nothing to disclose
Carsten Lukas1, (carsten.lukas@rub.de):
CL received a research grant by the German Federal Ministry for Education
and Research, BMBF, German Competence Network Multiple Sclerosis (KKNMS), grant no.01GI1601I, has received consulting and speaker´s honoraria from Biogen Idec, Bayer Schering, Daiichi Sankyo, Merck Serono, Novartis, Sanofi, Genzyme and TEVA.
1 Department of Radiology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
2 Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
Abstract: EP1443
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Comorbidity
Background: Developmental venous anomalies (DVAs) are congenital malformations of veins that drain the brain parenchyma. Their incidence has been reported to be 2.58% by a previous autopsy study, while magnetic resonance imaging (MRI) based studies reported a frequency of up to 9.3% in the healthy population.
Objective: Our aim was to determine the prevalence of DVAs in patients with clinically isolated syndrome (CIS) and early multiple sclerosis (MS) and to assess, whether DVAs are related to altered clinical, MRI and laboratory measures.
Methods: All 93 patients (39 CIS, 54 MS) underwent routine neurological- and MRI examination in a single center. DVAs were identified by two raters on post-contrast T1 weighted images. In addition, conventional measures such as clinical disability (n=93) and T2 lesion load (n=90), brain atrophy (n=89), as well as cerebrospinal fluid (CSF) parameters (n=< 82) were determined.
Results: 29 DVAs were detected in 25 patients (25/93; 26.9%); 10 out of 39 CIS patients and 15 out 54 MS patients had DVAs. The prevalence of DVAs did not differ between CIS and MS (p=0.819). In the total cohort of patients, clinical, MRI and laboratory parameters did not differ significantly between patients with and without DVAs, with the exception that a higher frequency of hypointense lesions on fluid-attenuated inversion recovery (FLAIR) sequences in patients with DVAs has been found (percentage of hypointense FLAIR lesions in patients with vs. without DVAs: 44% vs. 28.3%; p=0.037). CIS patients with DVAs had significantly less total ventricle volume (p=0.030) at baseline and showed higher CSF-levels of albumin (p=0.004), immunoglobulin G (p=0.021) and immunoglobulin A (p=0.017). Nethertheless, DVAs were not associated with higher conversion rates from CIS to MS at 1-year (p=0.411) or 2-year follow-up (p=0.281), respectively.
Conclusion: We have detected DVAs in patients with CIS or early MS at a higher frequency than published before. The percentage of DVAs in CIS and MS patients was 10 times higher than the prevalence reported in the healthy population. Patients with DVAs did not have significantly altered clinical outcomes, brain atrophy rates and disease progression. Accordingly, CIS Patients with DVAs do not seem to be at higher risk for converting to MS.
Disclosure: Patrick Kruczek1, (patrick.kruczek@rub.de):
nothing to disclose
Barbara Bellenberg1, (barbara.bellenberg@rub.de):
BB received financial support by the German Federal Ministry for Education and
Research, BMBF, German Competence Network Multiple Sclerosis (KKNMS), grant no. 01GI1601I
Theodor Lutz1, (t.lutz@klinikum-bochum.de):
nothing to disclose
Ruth Schneider2, (ruth.schneider@rub.de):
nothing to disclose
Christian Ahlborn1, (christian.ahlborn@rub.de):
nothing to disclose
Ralf Gold2, (ralf.gold@rub.de):
RG received speaker's and board honoraria from Baxter, Bayer Schering, Biogen Idec, CLB Behring, Genzyme, Merck Serono, Novartis, Stendhal, Talecris, TEVA; his department received grant support from Bayer Schering, Biogen Idec, Genzyme, Merck Serono, Novartis, TEVA.
Odo Köster1, (odo.koester@rub.de):
nothing to disclose
Carsten Lukas1, (carsten.lukas@rub.de):
CL received a research grant by the German Federal Ministry for Education
and Research, BMBF, German Competence Network Multiple Sclerosis (KKNMS), grant no.01GI1601I, has received consulting and speaker´s honoraria from Biogen Idec, Bayer Schering, Daiichi Sankyo, Merck Serono, Novartis, Sanofi, Genzyme and TEVA.
1 Department of Radiology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
2 Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany