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Relapse numbers and earlier intervention by disease modifying drugs are related with progression of less brain atrophy in patients with multiple sclerosis

      Highlights

      • Preventing brain atrophy of patients with MS is an urgent matter.
      • Annualized atrophy rate of NBV and attack number was significantly correlated.
      • Time from drug initiation was negatively correlated with attack number.
      • Negative correlation was found between time from drug initiation and atrophy rate.

      Abstract

      Long term effect between disease-modifying drugs (DMDs) treatment duration and brain atrophy rate has not been fully investigated in patients with relapsing-remitting MS (RRMS). The aim of this study was to investigate whether DMDs could slow down the progression of brain atrophy in patients with RRMS by comparing DMDs-treated group with non-treated group during a certain period of time.
      This was a retrospective investigation. Forty-nine RRMS patients underwent two brain MRI scans more than one year apart. Between scans, patients were treated with fingolimod (n = 16), interferon-beta (n = 23) or not treated with DMD (n = 10). Correlations between clinical characteristics and brain volume were calculated by statistical parametric mapping-12.
      In all 49 patients, the total attack number before 1st MRI scan and the annualized rate of total lesion volume change between the two scans showed a positive correlation with annualized atrophy rate of grey matter volume (GMV) plus white matter volume (WMV). In patients with DMDs (n = 39), the period from drug initiation to 1st MRI scan was negatively correlated with the annualized atrophy rate of GMV + WMV and number of attacks between scans.
      The number of total previous attacks could be a predictor of subsequent MS progression. Early intervention by DMDs could prevent brain atrophy in patients with MS.

      Keywords

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      References

        • Polman C.H.
        • Reingold S.C.
        • Banwell B.
        • Clanet M.
        • Cohen J.A.
        • Filippi M.
        • Fujihara K.
        • Havrdova E.
        • Hutchinson M.
        • Kappos L.
        Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria.
        Ann. Neurol. 2011; 69: 292-302
        • Rae-Grant M. Alexander
        • Fox R.
        • Bethoux F.
        Multiple Sclerosis and Related Disorders: Diagnosis, Medical Management, and Rehabilitation.
        Demos Medical Publishing, 2013
        • Paul F.
        Pathology and MRI: exploring cognitive impairment in MS.
        Acta Neurol. Scand. 2016; 134 Suppl 200: 24-33
        • Campbell J.
        • Rashid W.
        • Cercignani M.
        • Langdon D.
        Cognitive impairment among patients with multiple sclerosis: associations with employment and quality of life.
        Postgrad. Med. J. 2017; 93: 143-147
        • Azevedo C.J.
        • Overton E.
        • Khadka S.
        • Buckley J.
        • Liu S.
        • Sampat M.
        • Kantarci O.
        • Lebrun Frenay C.
        • Siva A.
        • Okuda D.T.
        • Pelletier D.
        Early CNS neurodegeneration in radiologically isolated syndrome.
        Neurol. Neuroimmunol. Neuroinflamm. 2015; 2: e102
        • Zivadinov R.
        • Locatelli L.
        • Cookfair D.
        • Srinivasaraghavan B.
        • Bertolotto A.
        • Ukmar M.
        • Bratina A.
        • Maggiore C.
        • Bosco A.
        • Grop A.
        • Catalan M.
        • Zorzon M.
        Interferon beta-1a slows progression of brain atrophy in relapsing-remitting multiple sclerosis predominantly by reducing gray matter atrophy.
        Mult. Scler. 2007; 13: 490-501
        • Yousuf F.
        • Dupuy S.L.
        • Tauhid S.
        • Chu R.
        • Kim G.
        • Tummala S.
        • Khalid F.
        • Weiner H.L.
        • Chitnis T.
        • Healy B.C.
        • Bakshi R.
        A two-year study using cerebral gray matter volume to assess the response to fingolimod therapy in multiple sclerosis.
        J. Neurol. Sci. 2017; 383: 221-229
        • Kappos L.
        • Radue E.W.
        • O'Connor P.
        • Polman C.
        • Hohlfeld R.
        • Calabresi P.
        • Selmaj K.
        • Agoropoulou C.
        • Leyk M.
        • Zhang-Auberson L.
        • Burtin P.
        A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis.
        N. Engl. J. Med. 2010; 362: 387-401
        • Calabresi P.A.
        • Radue E.W.
        • Goodin D.
        • Jeffery D.
        • Rammohan K.W.
        • Reder A.T.
        • Vollmer T.
        • Agius M.A.
        • Kappos L.
        • Stites T.
        • Li B.
        • Cappiello L.
        • von Rosenstiel P.
        • Lublin F.D.
        Safety and efficacy of fingolimod in patients with relapsing-remitting multiple sclerosis (FREEDOMS II): a double-blind, randomised, placebo-controlled, phase 3 trial.
        Lancet Neurol. 2014; 13: 545-556
        • Perez-Miralles F.C.
        • Sastre-Garriga J.
        • Vidal-Jordana A.
        • Rio J.
        • Auger C.
        • Pareto D.
        • Tintore M.
        • Rovira A.
        • Montalban X.
        Predictive value of early brain atrophy on response in patients treated with interferon beta.
        Neurol. Neuroimmunol. Neuroinflamm. 2015; 2: e132
        • Zivadinov R.
        • Jakimovski D.
        • Gandhi S.
        • Ahmed R.
        • Dwyer M.G.
        • Horakova D.
        • Weinstock-Guttman B.
        • Benedict R.R.
        • Vaneckova M.
        • Barnett M.
        • Bergsland N.
        Clinical relevance of brain atrophy assessment in multiple sclerosis. Implications for its use in a clinical routine.
        Expert. Rev. Neurother. 2016; 16: 777-793
        • Martola J.
        • Bergstrom J.
        • Fredrikson S.
        • Stawiarz L.
        • Hillert J.
        • Zhang Y.
        • Flodmark O.
        • Lilja A.
        • Ekbom A.
        • Aspelin P.
        • Wiberg M.K.
        A longitudinal observational study of brain atrophy rate reflecting four decades of multiple sclerosis: a comparison of serial 1D, 2D, and volumetric measurements from MRI images.
        Neuroradiology. 2010; 52: 109-117
        • Pelletier D.
        • Garrison K.
        • Henry R.
        Measurement of whole-brain atrophy in multiple sclerosis.
        J. Neuroimaging. 2004; 14 (Suppl): 11S-19S
        • Schmidt P.
        • Gaser C.
        • Arsic M.
        • Buck D.
        • Förschler A.
        • Berthele A.
        • Hoshi M.
        • Ilg R.
        • Schmid V.J.
        • Zimmer C.
        An automated tool for detection of FLAIR-hyperintense white-matter lesions in multiple sclerosis.
        Neuroimage. 2012; 59: 3774-3783
        • Rudick R.A.
        • Fisher E.
        • Lee J.C.
        • Duda J.T.
        • Simon J.
        Brain atrophy in relapsing multiple sclerosis: relationship to relapses, EDSS, and treatment with interferon beta-1a.
        Mult. Scler. 2000; 6: 365-372
        • Comi G.
        • Patti F.
        • Rocca M.A.
        • Mattioli F.C.
        • Amato M.P.
        • Gallo P.
        • Centonze D.
        • Pozzilli C.
        • Sacca F.
        • Bergh F.T.
        • Bartezaghi M.
        • Turrini R.
        • Filippi M.
        Efficacy of fingolimod and interferon beta-1b on cognitive, MRI, and clinical outcomes in relapsing-remitting multiple sclerosis: an 18-month, open-label, rater-blinded, randomised, multicentre study (the GOLDEN study).
        J. Neurol. 2017; 264: 2436-2449
        • Radue E.W.
        • Sprenger T.
        • Gaetano L.
        • Mueller-Lenke N.
        • Cavalier S.
        • Thangavelu K.
        • Panzara M.A.
        • Donaldson J.E.
        • Woodward F.M.
        • Wuerfel J.
        • Wolinsky J.S.
        • Kappos L.
        Teriflunomide slows BVL in relapsing MS: a reanalysis of the TEMSO MRI data set using SIENA.
        Neurol. Neuroimmunol. Neuroinflamm. 2017; 4: e390
        • Zivadinov R.
        • Reder A.T.
        • Filippi M.
        • Minagar A.
        • Stuve O.
        • Lassmann H.
        • Racke M.K.
        • Dwyer M.G.
        • Frohman E.M.
        • Khan O.
        Mechanisms of action of disease-modifying agents and brain volume changes in multiple sclerosis.
        Neurology. 2008; 71: 136-144