PMID- 36362428
OWN - NLM
STAT- MEDLINE
DCOM- 20221114
LR  - 20221117
IS  - 1422-0067 (Electronic)
IS  - 1422-0067 (Linking)
VI  - 23
IP  - 21
DP  - 2022 Nov 7
TI  - Changes in Brain Volumes Are Relevant during Natalizumab-Associated Progressive 
      Multifocal Leukoencephalopathy: Lessons from a Case Report.
LID - 10.3390/ijms232113642 [doi]
LID - 13642
AB  - This is a case report concerning a Natalizumab-associated Progressive Multifocal 
      Leukoencephalopathy (PML) with cerebellar localization and wakefulness 
      disturbances. Awakening and clinical improvement dramatically occurred as soon as 
      the immune reconstitution inflammatory syndrome (IRIS) took place, being it mild 
      in nature and colocalizing with the PML lesion. In these ideal experimental 
      conditions, we applied brain magnetic resonance imaging post-analysis in order to 
      know changes in brain volumes underlying the pathological process over the 
      infection period. White matter volume increased with a decrease in grey matter 
      during IRIS. Conversely, we found a constant increase in cerebrospinal fluid 
      volume throughout the duration of PML, suggesting a widespread abiotrophic 
      effect, far from the lesion. Furthermore, brain parenchymal fraction 
      significantly decreased as expected while the total brain volume remained stable 
      at all times. Neurodegeneration is the main contributor to the steady disability 
      in Natalizumab-associated PML. This process is thought to be widespread and 
      inflammatory in nature as well as sustained by IRIS and humoral factors derived 
      from the PML lesion.
FAU - De Masi, Roberto
AU  - De Masi R
AUID- ORCID: 0000-0002-7587-8112
AD  - Complex Operative Unit of Neurology, "F. Ferrari" Hospital, 73042 Casarano, 
      Italy.
AD  - Laboratory of Neuroproteomics, Multiple Sclerosis Centre, "F. Ferrari" Hospital, 
      73042 Casarano, Italy.
FAU - Orlando, Stefania
AU  - Orlando S
AUID- ORCID: 0000-0003-2403-9228
AD  - Laboratory of Neuroproteomics, Multiple Sclerosis Centre, "F. Ferrari" Hospital, 
      73042 Casarano, Italy.
FAU - Armenise, Silvia
AU  - Armenise S
AD  - Complex Operative Unit of Radiology, "F. Ferrari" Hospital, 73042 Casarano, 
      Italy.
FAU - Spagnolo, Pantaleo
AU  - Spagnolo P
AD  - Complex Operative Unit of Radiology, "F. Ferrari" Hospital, 73042 Casarano, 
      Italy.
FAU - Capra, Ruggero
AU  - Capra R
AUID- ORCID: 0000-0002-4338-3406
AD  - Multiple Sclerosis Centre, Spedali Civili di Brescia, 25123 Brescia, Italy.
FAU - Costa, Maria Carmela
AU  - Costa MC
AD  - Complex Operative Unit of Ophthalmology, "V. Fazzi" Hospital, 73100 Lecce, Italy.
LA  - eng
PT  - Case Reports
DEP - 20221107
PL  - Switzerland
TA  - Int J Mol Sci
JT  - International journal of molecular sciences
JID - 101092791
RN  - 0 (Natalizumab)
SB  - IM
MH  - Humans
MH  - Natalizumab/adverse effects
MH  - *Leukoencephalopathy, Progressive Multifocal/diagnostic 
      imaging/etiology/pathology
MH  - *Immune Reconstitution Inflammatory Syndrome/etiology/complications
MH  - Magnetic Resonance Imaging
MH  - Brain/diagnostic imaging/pathology
MH  - *Multiple Sclerosis/pathology
PMC - PMC9653865
OTO - NOTNLM
OT  - JC virus
OT  - MRI post-processing
OT  - brain segmentation
OT  - multiple sclerosis
OT  - progressive multifocal leukoencephalopathy
COIS- The authors declare no conflict of interest.
EDAT- 2022/11/12 06:00
MHDA- 2022/11/15 06:00
PMCR- 2022/11/07
CRDT- 2022/11/11 01:30
PHST- 2022/09/16 00:00 [received]
PHST- 2022/10/24 00:00 [revised]
PHST- 2022/11/04 00:00 [accepted]
PHST- 2022/11/11 01:30 [entrez]
PHST- 2022/11/12 06:00 [pubmed]
PHST- 2022/11/15 06:00 [medline]
PHST- 2022/11/07 00:00 [pmc-release]
AID - ijms232113642 [pii]
AID - ijms-23-13642 [pii]
AID - 10.3390/ijms232113642 [doi]
PST - epublish
SO  - Int J Mol Sci. 2022 Nov 7;23(21):13642. doi: 10.3390/ijms232113642.