Evidence map›Paper›PMID 34014144›Full record

ArticleMultiple sclerosis (Houndmills, Basingstoke, England)2022

Sensitivity of T1/T2-weighted ratio in detection of cortical demyelination is similar to magnetization transfer ratio using post-mortem MRI.

Yufan Zheng, Jessica Dudman, Jacqueline T Chen, Kedar R Mahajan, Danielle Herman, Robert J Fox, Daniel Ontaneda, Bruce D Trapp, Kunio Nakamura

Open access · greenAbstract read
In one paragraph

Article in Multiple sclerosis (Houndmills, Basingstoke, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
3.3field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.

  1. Pooled it
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  7. Review
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  10. GdProceedings of the National Academy of Sciences of the United States of America · 2022
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  11. T1/T2-weighted ratio is a surrogate marker of demyelination in multiple sclerosis: No.Multiple sclerosis (Houndmills, Basingstoke, England) · 2022
    Article
  12. Article
  13. TJournal of neuroimaging : official journal of the American Society of Neuroimaging
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Yufan ZhengDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.ORCID 0000-0001-9065-9674
Jessica DudmanDepartment of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Jacqueline T ChenDepartment of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Kedar R MahajanDepartment of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA/Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.ORCID 0000-0002-0339-9876
Danielle HermanDepartment of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Robert J FoxMellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.ORCID 0000-0002-4263-3717
Daniel OntanedaMellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.ORCID 0000-0002-2838-9148
Bruce D TrappDepartment of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Kunio NakamuraDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.ORCID 0000-0002-7833-8138
Cleveland Clinic Lerner College of Medicine · USCleveland Clinic · US

Funding

TISSUE INJURY AND INFLAMMATION IN MULTIPLE SCLEROSISP01NS038667 · NINDS · CLEVELAND CLINIC LERNER COM-CWRU · PI RANSOHOFF, RICHARD M. · 2000 to 2007
$8.1M
Pathogenesis of Neurological Disability in Primary Diseases of MyelinR35NS097303 · NINDS · CLEVELAND CLINIC LERNER COM-CWRU · PI TRAPP, BRUCE D · 2017 to 2024
$6.9M
Thalamic MRI, histopathologic, and clinical correlations in multiple sclerosisK23NS109328 · NINDS · CLEVELAND CLINIC LERNER COM-CWRU · PI MAHAJAN, KEDAR · 2018 to 2022
$919k
NINDS NIH HHS K23 NS109328NINDS NIH HHS P01 NS038667NINDS NIH HHS R35 NS097303
6 · The paper itself

Abstract

backgroundDetecting cortical demyelination using magnetic resonance imaging (MRI) in multiple sclerosis (MS) remains a challenge. Magnetization transfer ratio (MTR), T1-weighted/T2-weighted ratio (T1T2R), and T2-weighted (T2w) signal are sensitive to cortical demyelination, but their accuracy is unknown.

objectivesTo quantify the sensitivity, specificity, and accuracy of postmortem T1T2R, MTR, and T2w in detecting cortical demyelination.

methods

resultsThe mean age (standard deviation) at death was 64.7 (+/-13.7) years with a disease duration of 23.8 (+/-10.5) years. The sensitivity was 78% for MTR, 75% for T1T2R, and 63% for T2w. The specificity was 46% (T2w), 13% (T1T2R), and 29% (MTR). The accuracy was 71% (T2w), 39% (MTR), and 42% (T1T2R). There were no significant differences between different MRI measures in cortical demyelination or intracortical/subpial lesion detection.

conclusionsAlthough somewhat sensitive, the modest specificity of conventional MRI modalities for cortical demyelination indicates that they are influenced by cortical changes other than demyelination. Improved acquisition and post-processing are needed to reliably measure cortical lesion load.

Indexed as

Magnetic Resonance ImagingMultiple SclerosisAgedAutopsyBrainGray MatterHumansMiddle AgedMyelin SheathCortical demyelinationhistology-MRI correlationmagnetization transfer ratioMRImultiple sclerosisPLPT1-to-T2 ratio

Identifiers

PMID34014144
PMCPMC8605037
OpenAlexW3162348472

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.