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Focal cortical atrophy following transient meningeal enhancement in a progressive multiple sclerosis

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Abstract

Recent studies identified chronic leptomeningeal enhancement (LME) in late-acquired FLAIR sequences in secondary progressive (SP) multiple sclerosis (MS). These LMEs correlate with focal cortical inflammation and demyelination observed by pathology, which are supposed to drive long-term cortical atrophy. We report a spontaneously remitting meningeal uptake in a patient suffering from SP MS. No cortical lesion was visible on FLAIR or DIR sequences, but the rate of cortical atrophy was higher in this area. This case suggests that conventional 3-T MRI, by contrary to white matter lesions, may be amnesic with regard to the potential burden of previous regressive meningeal lesions. Moreover, T1-enhanced sequences underscore the real inflammatory activity. LME could be more than passive markers of SP MS, but is also directly responsible for focal cortical atrophy and could be an early manifestation of cortical lesions.

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Acknowledgements

We are indebted to Ray Cooke for copyediting and to Laure Ferran for technical assistance.

Funding

This study is part of the NCT02545959 trial that received GIRCI-SOOM financial support. The authors received no financial support for the authorship or publication of the article.

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Authors and Affiliations

  1. Neurologie, Centre hospitalier de Pau, 4 Bd Hauterive, 64000, Pau, France

    Mickael Bonnan, Raluca Marasescu, Lise-Marlène Puvilland, Stéphanie Demasles, Camille Dahan, Elsa Krim & Bruno Barroso

  2. Radiologie, Centre hospitalier de Pau, 4 Bd Hauterive, 64000, Pau, France

    Paul Money & Pauline Desblache

  3. Pixyl Medical, La Tronche, France

    Alan Tucholka & Senan Doyle

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  1. Mickael Bonnan
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  2. Paul Money
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  3. Pauline Desblache
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  4. Raluca Marasescu
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  5. Lise-Marlène Puvilland
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  6. Stéphanie Demasles
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  7. Camille Dahan
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  8. Elsa Krim
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  9. Alan Tucholka
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  10. Senan Doyle
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  11. Bruno Barroso
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Corresponding author

Correspondence to Mickael Bonnan.

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The authors declare that they have no conflict of interest.

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This study was approved by the local research ethics committee and all procedures performed in studies were in accordance with ethical standards.

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Bonnan, M., Money, P., Desblache, P. et al. Focal cortical atrophy following transient meningeal enhancement in a progressive multiple sclerosis. Neurol Sci 42, 1959–1961 (2021). https://doi.org/10.1007/s10072-020-04764-0

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  • DOI: https://doi.org/10.1007/s10072-020-04764-0

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