OBJECTIVE: Multiple sderosis (MS) patients develop varying degrees of cerebral atrophy, which may already begin at disease onset The purpose of this study is to examine the effect of steroid treatment on cerebral volume in MS patients. METHODS: Thirty-five MS patients participating in a clinical trial of oral interferon beta, which induded monthly MRI, were included in this study. They suffered from an acute relapse and were treated with intravenous methylprednisolone (IV-MP); 13 of the patients were treated with oral prednisolone tapering after IV-MP. The last MRI scan before and the first (and second for oral tapering patients) scan after IV-MP treatment were used for measuring parenchymal fraction (PF) and ventricular fraction (VF). Changes in PF and VF were analysed using Student's t test. RESULTS: For the total population no significant changes in PF or VF were found. However, the subgroup of patients receiving oral tapering after IV-MP showed changes, compatible with atrophy in both PF and VF, that were significant immediately after IV-MP treatment and still persisted (though not statistically significant anymore) after a mean interval of 30 days. The magnitude of these changes was about the same as the annual change in cerebral volume as reported in natural history studies. CONCLUSION: Our data indicate that short courses of intravenous steroids (restricted to three or five days) have no major impact, whereas prolonged treatment with oral tapering does significantly affect brain volume. These findings are important for longitudinal studies and clinical trials in which brain volume is used as an outcome measure.
OBJECTIVE:Multiple sderosis (MS) patients develop varying degrees of cerebral atrophy, which may already begin at disease onset The purpose of this study is to examine the effect of steroid treatment on cerebral volume in MSpatients. METHODS: Thirty-five MSpatients participating in a clinical trial of oral interferon beta, which induded monthly MRI, were included in this study. They suffered from an acute relapse and were treated with intravenous methylprednisolone (IV-MP); 13 of the patients were treated with oral prednisolone tapering after IV-MP. The last MRI scan before and the first (and second for oral tapering patients) scan after IV-MP treatment were used for measuring parenchymal fraction (PF) and ventricular fraction (VF). Changes in PF and VF were analysed using Student's t test. RESULTS: For the total population no significant changes in PF or VF were found. However, the subgroup of patients receiving oral tapering after IV-MP showed changes, compatible with atrophy in both PF and VF, that were significant immediately after IV-MP treatment and still persisted (though not statistically significant anymore) after a mean interval of 30 days. The magnitude of these changes was about the same as the annual change in cerebral volume as reported in natural history studies. CONCLUSION: Our data indicate that short courses of intravenous steroids (restricted to three or five days) have no major impact, whereas prolonged treatment with oral tapering does significantly affect brain volume. These findings are important for longitudinal studies and clinical trials in which brain volume is used as an outcome measure.
Authors: Jitendra Sharma; Michael P Sanfilipo; Ralph H B Benedict; Bianca Weinstock-Guttman; Frederick E Munschauer; Rohit Bakshi Journal: AJNR Am J Neuroradiol Date: 2004 Jun-Jul Impact factor: 3.825
Authors: F Durand-Dubief; B Belaroussi; J P Armspach; M Dufour; S Roggerone; S Vukusic; S Hannoun; D Sappey-Marinier; C Confavreux; F Cotton Journal: AJNR Am J Neuroradiol Date: 2012-07-12 Impact factor: 3.825
Authors: Stefan C A Steens; Gerda M Steup-Beekman; Gerlof P Th Bosma; Faiza Admiraal-Behloul; Hans Olofsen; Joost Doornbos; Tom W J Huizinga; Mark A van Buchem Journal: AJNR Am J Neuroradiol Date: 2005 Nov-Dec Impact factor: 3.825