title: Are Periventricular Lesions Specific for Multiple Sclerosis?
abstract: BACKGROUND
  The presence of periventricular lesions (PVL) on MRI scans is part of the revised McDonald multiple sclerosis (MS) diagnostic criteria. However, PVL can be found in other neurological diseases including stroke and migraine. Migraine is highly prevalent in patients with MS.
  
  
  OBJECTIVE
  To determine if PVL are specific for patients with MS compared to stroke and migraine.
  
  
  METHODS
  We studied patients diagnosed with clinically isolated syndrome (CIS), relapsing-remitting MS (RRMS), migraine, and ischemic stroke. The number, location and the volume of PVL were identified on brain MRI scans and analyzed.
  
  
  RESULTS
  The number and volume of PVL adjacent to the body and the posterior horn of the lateral ventricles were significantly increased on fluid-attenuated inversion recovery MRI in RRMS compared to migraine. There were no significant differences in the total number and volume of PVL in ischemic stroke patients compared to the age-matched RRMS patients nor in the number and volume of PVL adjacent to the anterior and temporal horns of the lateral ventricles on FLAIR images in migraine compared to CIS or RRMS.
  
  
  CONCLUSIONS
  In contrast to PVL adjacent to the body and the posterior horn of the lateral ventricles, PVL adjacent to the anterior and temporal horns of the lateral ventricles may not be specific for CIS/RRMS when compared to migraine, the disease highly prevalent among patients with MS. PVL are not specific for MS when compared to ischemic stroke.
authors.affiliation: Department of Neurology, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
authors.forename: Gianna
authors.initials: G
authors.lastname: Casini
authors.affiliation: Department of Neurology, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Yurashevich
authors.affiliation: Department of Neurology, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
authors.forename: Rohini
authors.initials: R
authors.lastname: Vanga
authors.affiliation: Department of Neurology, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
authors.forename: Subasini
authors.initials: S
authors.lastname: Dash
authors.affiliation: Department of Neurology, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
authors.forename: Suhayl
authors.initials: S
authors.lastname: Dhib-Jalbut
authors.affiliation: Department of Neurology, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Gerhardstein
authors.affiliation: Department of Neurology, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
authors.forename: Matilde
authors.initials: M
authors.lastname: Inglese
authors.affiliation: Department of Neurology, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
authors.forename: Win
authors.initials: W
authors.lastname: Toe
authors.affiliation: Department of Neurology, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
authors.forename: Konstantin E
authors.initials: KE
authors.lastname: Balashov
keywords: MRI; Migraine; Multiple sclerosis; Stroke