Author Of 3 Presentations
LB1246 - Future implementation of automated analysis tools for Multiple Sclerosis on conventional magnetic resonance imaging. (ID 2132)
Abstract
Background
Magnetic resonance imaging (MRI) is imperative for the detection and characterization of Multiple Sclerosis (MS) lesions in the central nervous system. The revised McDonald's criteria of 2017 involve brain and spinal cord MRI lesions with respect to dissemination in time and space to aid in establishing the diagnosis. Furthermore, MRI is the principal tool of tracking brain and spinal cord changes and monitoring treatment effects and disease progression. Manual evaluation of multiple evolving MS lesions and particularly estimation of brain atrophy is difficult due to the time-consuming nature of longitudinal assessment, the complexity of brain volume estimation, and is subject to significant inter-observer variability.
Objectives
This study aims to survey current commercial and freeware automated tools for lesion identification and brain volume monitoring. We evaluate the feasibility and identify barriers in the adoption of computerized tools in the clinical setting.
Methods
A literature search was performed in PubMed, and Google Scholar databases and publications on automated image evaluation tools in multiple sclerosis were identified and reviewed. Findings in other neurologic populations supplemented limited evidence on reliability and validity.
Results
We evaluated various existing automated software packages suitable and specifically developed for the multiple sclerosis population, including SepINRIA, Icobrain, DeepMedic, and others. We confirmed the benefits of image analysis automation. We describe differences between available software models, their advantages and disadvantages. Notably, we identify challenges faced by existing software implementations representing an obstacle to their wide adoption, such as hardware requirements, price of purchase and maintenance, absence of a gold standard, and uncertainty of healthcare benefits.
Conclusions
After exploring the barriers, we propose solutions to integrating automated image analysis into routine practice through the development of a quality assurance and decision support system.
LB1263 - Introduction of CSF immunoglobulin κ light chains testing as a complement to oligoclonal bands evaluation (ID 2160)
Abstract
Background
Background: Detection of oligoclonal (OB) bands in the cerebrospinal fluid (CSF) is an essential tool in the diagnosis of autoimmune inflammatory conditions of the CNS and particularly multiple sclerosis (MS). This method is known to have significant limitations: it is labour intensive, interpretation and evaluation should be restricted to experienced specialists (subjective), standards for testing are frequently absent creating difficulties with reproducibility across labs, it is qualitative, and potentially can be affected by patient's use of therapeutic monoclonal immunoglobulins. Free κ light chain production is known to increase with immune system activation, including autoimmune diseases and can be used for their detection. κ light chains are known to be present in the CSF of patients with MS.
Objectives
Our study's goal was to perform an analysis of κ light chains in CSF and compare results with findings of OB evaluation in the spectrum of neurological conditions including MS.
Methods
200 CSF samples from the regional laboratory were analyzed for both OB bands and κ light chain concentrations. The sensitivity and specificity of each method were evaluated concerning the clinical diagnosis of MS.
Results
κ light chain concentration can be reliably performed in a hospital laboratory setting. This test has excellent sensitivity and specificity to the clinical diagnosis of MS.
Conclusions
Introducing routine reporting of κ light chains CSF concentration will increase confidence in the reproducibility of results, it will help to firmly establish quantitative normative values, and their relationship to meaningful clinical outcomes. κ light chains test is a useful complement to OB bands testing. It has the capacity to replace it over time and provide a quantitative dimension to the evaluation of CNS inflammation.
LB1277 - Evaluation of intermittent fasting diet in multiple sclerosis (ID 2176)
Abstract
Background
Intermittent fasting (IF) has been explored in recent years as a potential intervention in multiple sclerosis (MS) due to the growing evidence on the possible links between diet, caloric intake and inflammation. IF is also relatively easy to implement, and can be readily monitored using urine ketones. Current evidence on IF in delaying MS progression is limited due to a lack of high-quality clinical trials, short duration of intervention, and heterogeneity in experimental design and parameters investigated. Imaging evidence from FLAIR MRI, a hallmark in MS diagnosis and the detection of disease progression, is mostly absent from the current literature.
Objectives
The primary objective of the study was to review current evidence on intermittent fasting in the setting of MS. A secondary goal was to identify gaps in knowledge and barriers to the practical implementation of IF.
Methods
PUBMED and EMBASE datasets were queried on the studies of IF in MS. Clinical trials database was queried to identify active ongoing clinical trials.
Results
Eight IF-related studies were identified. The advantages and disadvantages of each project were evaluated and reported.
Conclusions
Considering the current evidence, IF represents a useful dietary intervention. However, more studies are needed to demonstrate its clinical benefits to establish long-term feasibility, particularly in the early stages of MS. A new study of IF that includes patient compliance monitoring, magnetic resonance imaging, and biological markers evaluation in patients with clinically isolated syndrome (CIS) is proposed.
Presenter Of 1 Presentation
LB1277 - Evaluation of intermittent fasting diet in multiple sclerosis (ID 2176)
Abstract
Background
Intermittent fasting (IF) has been explored in recent years as a potential intervention in multiple sclerosis (MS) due to the growing evidence on the possible links between diet, caloric intake and inflammation. IF is also relatively easy to implement, and can be readily monitored using urine ketones. Current evidence on IF in delaying MS progression is limited due to a lack of high-quality clinical trials, short duration of intervention, and heterogeneity in experimental design and parameters investigated. Imaging evidence from FLAIR MRI, a hallmark in MS diagnosis and the detection of disease progression, is mostly absent from the current literature.
Objectives
The primary objective of the study was to review current evidence on intermittent fasting in the setting of MS. A secondary goal was to identify gaps in knowledge and barriers to the practical implementation of IF.
Methods
PUBMED and EMBASE datasets were queried on the studies of IF in MS. Clinical trials database was queried to identify active ongoing clinical trials.
Results
Eight IF-related studies were identified. The advantages and disadvantages of each project were evaluated and reported.
Conclusions
Considering the current evidence, IF represents a useful dietary intervention. However, more studies are needed to demonstrate its clinical benefits to establish long-term feasibility, particularly in the early stages of MS. A new study of IF that includes patient compliance monitoring, magnetic resonance imaging, and biological markers evaluation in patients with clinically isolated syndrome (CIS) is proposed.