title: Cortical lesions in radiologically isolated syndrome.
abstract: OBJECTIVE
  To assess the presence of cortical lesions (CLs) as detected by MRI in subjects with radiologically isolated syndrome (RIS).
  
  
  METHODS
  Fifteen subjects with RIS underwent an MRI examination, including a double inversion recovery sequence for CL assessment. T2-hyperintense white matter (WM) lesion volume (LV) and normalized volumes of brain and cortex were also obtained.
  
  
  RESULTS
  Thirty-four CLs were identified in 6 of 15 (40%) subjects with RIS and predominantly distributed in frontotemporal lobes. CLs were frequent in subjects with RIS with immunoglobulin G oligoclonal bands on CSF, cervical cord lesions, and dissemination in time on brain MRI. WM LV was higher in subjects with CLs than in those without CLs (11.5 ± 10.1 vs 3.9 ± 2.8 cm(3), p = 0.04). Indeed, CL number and volume correlated with WM LV (r = 0.57, p = 0.03 and r = 0.61, p = 0.01). All subjects with CLs were classified in a previous study as having a very high probability of having relapsing-remitting multiple sclerosis (MS) on a logistic regression analysis of quantitative MRI indices.
  
  
  CONCLUSIONS
  We found CLs in subjects with RIS, a condition characterized by the unanticipated MRI finding of WM lesions highly suggestive of MS in the absence of a clinical scenario. CLs were mainly localized to the frontotemporal lobes and were associated with important markers of evolution to MS.
authors.affiliation: Department of Neurological and Behavioral Sciences, University of Siena, Siena, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Giorgio
authors.forename: M L
authors.initials: ML
authors.lastname: Stromillo
authors.forename: F
authors.initials: F
authors.lastname: Rossi
authors.forename: M
authors.initials: M
authors.lastname: Battaglini
authors.forename: B
authors.initials: B
authors.lastname: Hakiki
authors.forename: E
authors.initials: E
authors.lastname: Portaccio
authors.forename: A
authors.initials: A
authors.lastname: Federico
authors.forename: M P
authors.initials: MP
authors.lastname: Amato
authors.forename: N
authors.initials: N
authors.lastname: De Stefano
mesh_terms: D000328:Adult; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000175:diagnosis*; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D055815:Young Adult