title: HAM/TSP: association between white matter lesions on magnetic resonance imaging, clinical and cerebrospinal fluid findings.
abstract: OBJECTIVE
  To investigate the association between clinical data, white matter lesions and inflammatory cerebrospinal fluid (CSF) findings in HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP).
  
  
  METHODS
  We studied brain and cervical spinal cord on magnetic resonance imaging (MRI) and CSF examinations of 28 Brazilian HAM/TSP patients.
  
  
  RESULTS
  The majority of patients had severe neurological incapacity with EDSS median of 6.5 (3-8). The brain MRI showed white matter lesions (75%) and atrophy (14%). The preferential brain location was periventricular. Cervical demyelination lesions occurred in 11% of the cases, and cervical atrophy in 3.5%. One patient had enhancement lesions on T1 cervical spinal cord MRI. Cases with spinal cord lesions had signs of acute CSF inflammation. The brain white matter lesions predominated in the patients with higher age.
  
  
  CONCLUSIONS
  Our data suggest that an active inflammatory process is associated with the cervical spinal cord lesions in HAM/TSP. The brain abnormalities are not related to the clinical picture of HAM/TSP.
authors.affiliation: Clinical Pathology Service/Cerebrospinal Fluid Laboratory, University Hospital Clementino Fraga Filho of the Federal University of Rio de Janeiro, Brazil. mpuccioni@hucff.ufrj.br
authors.forename: Marzia
authors.initials: M
authors.lastname: Puccioni-Sohler
authors.forename: Emerson
authors.initials: E
authors.lastname: Gasparetto
authors.forename: Mauro Jorge
authors.initials: MJ
authors.lastname: Cabral-Castro
authors.forename: Carla
authors.initials: C
authors.lastname: Slatter
authors.forename: Cecilia M
authors.initials: CM
authors.lastname: Vidal
authors.forename: Romeu Domingues
authors.initials: RD
authors.lastname: Cortes
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Rosen
authors.forename: Caterina
authors.initials: C
authors.lastname: Mainero
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy / Q000134:cerebrospinal fluid / Q000473:pathology; D001921:Brain / Q000473:pathology* / Q000821:virology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000134:cerebrospinal fluid* / Q000473:pathology*; D011446:Prospective Studies; D013116:Spinal Cord / Q000473:pathology / Q000821:virology