Differential white and gray matter damage in highly active multiple sclerosis: A prospective cohort study |
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| Affiliation: | 1. Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina;2. Laboratory of Immunomodulators – Center for Pharmacological and Botanical Studies (CEFYBO), School of Medicine, University of Buenos Aires – National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina;1. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada;2. Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada;3. Division of Neurosurgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada;4. Neuropathology Section, Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada;1. Sorbonne Universités – Department of Neuropathology, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France;2. Sorbonne Universités – Department of Electrophysiology, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France;3. Sorbonne Universités – Department of Neurosurgery, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France;4. Neurofibromatosis Type 2 and Schwannomatosis Referral Center, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France;1. Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan;2. Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan;3. Department of Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan;1. Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, United States;2. Florida State School of Medicine, Orlando, FL, United States;3. Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States;4. Charlotte Neurosurgical Associates, Charlotte, NC, United States;5. Orthopaedic of Steamboat Springs, Steamboat Springs, CO, United States |
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| Abstract: | We analyze the differential brain volume changes in highly active multiple sclerosis (HAMS) vs. non-HAMS patients during the disease onset.MethodsHAMS was defined as: a) patients with 1 relapse in the previous year and at least 1 T1 gadolinium-enhancing lesion or 9 or more T2 lesions while on therapy with other disease modifying treatment (DMD); or b) patients with 2 or more relapses in the previous year, whether on DMD or not. High-resolution T1 weighted MRI scans were acquired at onset and every 12 months for 2 years. Lesion load and brain volume measurements were determined. At onset, gray matter volume (GMV) and white matter volume (WMV) tissue volumes were calculated using the SIENAX. Longitudinal changes were estimated by using SIENA to calculate the percentage of brain volume loss. Differences between volumes per group at onset and at the end of the follow up were established.Results64 patients, mean age 38.4 years, 35 (57%) women were included. A total of 14 (21%) were classified as HAMS. At onset, HAMS patients showed lower GMV and WMV volume compared with non-HAMS patients (p = 0.003 and p = 0.01, respectively). During the follow up, HAMS patients showed a higher decrease in GM volume compared with non-HAMS patients (-0.61 vs. – 0.77, p < 0.001) independent from new lesion as well as relapse rate activity during follow up.ConclusionHAMS increased rates of GMV atrophy over 24 months compared to non-HAMS patients independent from relapse rate and new T2 lesions. |
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| Keywords: | Highly active multiple sclerosis Multiple sclerosis HAMS Atrophy Gray matter White matter |
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