An MRI-defined measure of cerebral lesion severity to assess therapeutic effects in multiple sclerosisReportar como inadecuado




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Journal of Neurology

, Volume 263, Issue 3, pp 531–538

First Online: 11 January 2016Received: 09 September 2015Revised: 22 December 2015Accepted: 23 December 2015

Abstract

Assess the sensitivity of the Magnetic Resonance Disease Severity Scale MRDSS, based on cerebral lesions and atrophy, for treatment monitoring of glatiramer acetate GA in relapsing-remitting multiple sclerosis MS. This retrospective non-randomized pilot study included patients who started daily GA n = 23, age median, range 41 26.2, 53.1 years, Expanded Disability Status Scale EDSS score 1.0 0, 3.5, or received no disease-modifying therapy noDMT n = 21, age 44.8 28.2, 55.4, EDSS 0 0, 2.5 for 2 years. MRDSS was the sum of z-scores normalized to a reference sample of T2 hyperintense lesion volume T2LV, the ratio of T1 hypointense LV to T2LV T1-T2, and brain parenchymal fraction BPF multiplied by negative 1. The two groups were compared by Wilcoxon rank sum tests; within group change was assessed by Wilcoxon signed rank tests. Glatiramer acetate subjects had less progression than noDMT on T1-T2 median z-score change range, 0 −1.07, 1.20 vs. 0.41 −0.30, 2.51, p = 0.003 and MRDSS 0.01 −1.33, 1.28 vs. 0.46 −1.57, 2.46, p = 0.01; however, not on BPF 0.12 −0.18, 0.58 vs. 0.10 −1.47,0.50, p = 0.59 and T2LV −0.03 −0.90, 0.57 vs. 0.01 −1.69, 0.34, p = 0.40. While GA subjects worsened only on BPF 0.12 −0.18, 0.58, p = 0.001, noDMT worsened on BPF 0.10 −1.47, 0.50, p = 0.002, T1-T2 0.41 −0.30, 2.51, p = 0.0002, and MRDSS 0.46 −1.57, 2.46, p = 0.0006. These preliminary findings show the potential of two new cerebral MRI metrics to track MS therapeutic response. The T1-T2, an index of the destructive potential of lesions, may provide particular sensitivity to treatment effects.

KeywordsMRI Multiple sclerosis Glatiramer acetate Brain atrophy Composite scale  Download fulltext PDF



Autor: Gloria Kim - Shahamat Tauhid - Sheena L. Dupuy - Subhash Tummala - Fariha Khalid - Brian C. Healy - Rohit Bakshi

Fuente: https://link.springer.com/







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