title: MRI-detectable cortical lesions in the cerebellum and their clinical relevance in multiple sclerosis.
abstract: BACKGROUND
  The demonstration of cortical lesions (CL) in the cerebellum by magnetic resonance imaging (MRI) is hampered by technical and anatomical constraints.
  
  
  OBJECTIVE
  To investigate the occurrence of cerebellar CL and their correlation with cerebellar-related disability by combining Double Inversion Recovery (DIR) and Phase Sensitive Inversion Recovery (PSIR) MRI images in multiple sclerosis (MS) patients.
  
  
  METHODS
  40 MS patients (10 CIS/eRRMS, 24 RRMS, 6 SPMS), having a wide range of disability and disease duration, were enrolled. DIR and PSIR images were obtained with a 3T-MRI.
  
  
  RESULTS
  Cerebellar white matter lesions (WML) and/or CL were observed in 33/40 patients (82.5%) among which 14/40 had only CL. CL were demonstrated in 26/40 patients by DIR and in 31/40 by PSIR, and their number increased from CIS/eRRMS to SPMS. PSIR disclosed a significantly higher number of CL compared to DIR (RRMS: p=0.0008; SPMS: p=0.002). CL number correlates with the cerebellar Expanded Disability Status Score (EDSS) score (r=0.72, p<0.0001). No correlation was observed between supra-tentorial and cerebellar CL.
  
  
  CONCLUSIONS
  CL are detected by PSIR in the cerebellum of the majority of MS patients, are more than WML, increase with disease progression and strongly correlate with the cerebellar EDSS. Thus, the observation of CL in the cerebellum of MS at clinical onset might be useful for prognostic and therapeutic aims.
authors.affiliation: Department of Neurosciences DNS, The Multiple Sclerosis Centre - Veneto Region (CeSMuV), University Hospital of Padova, Italy favarettoalice@gmail.com.
authors.forename: Alice
authors.initials: A
authors.lastname: Favaretto
authors.affiliation: Department of Neurosciences DNS, The Multiple Sclerosis Centre - Veneto Region (CeSMuV), University Hospital of Padova, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lazzarotto
authors.affiliation: Department of Neurosciences DNS, The Multiple Sclerosis Centre - Veneto Region (CeSMuV), University Hospital of Padova, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Poggiali
authors.affiliation: Neuroradiology Unit, University Hospital of Padova, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rolma
authors.affiliation: Neuroradiology Unit, University Hospital of Padova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Causin
authors.affiliation: Department of Neurosciences DNS, The Multiple Sclerosis Centre - Veneto Region (CeSMuV), University Hospital of Padova, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Rinaldi
authors.affiliation: Department of Neurosciences DNS, The Multiple Sclerosis Centre - Veneto Region (CeSMuV), University Hospital of Padova, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Perini
authors.affiliation: Department of Neurosciences DNS, The Multiple Sclerosis Centre - Veneto Region (CeSMuV), University Hospital of Padova, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gallo
mesh_terms: D000293:Adolescent; D000328:Adult; D002525:Cerebellar Cortex / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003711:Demyelinating Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000000981:diagnostic imaging* / Q000503:physiopathology; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011237:Predictive Value of Tests; D055815:Young Adult
keywords: Multiple sclerosis; cerebellum; cortical lesions; double inversion recovery; phase sensitive inversion recovery