OBJECTIVE: To investigate the temporal relationship between inflammation and cerebral atrophy in a longitudinal study of 19 patients with relapsing-remitting multiple sclerosis (RRMS) using serial monthly contrast enhanced MRI examinations and monthly measurements of brain fractional volume (BFV) for an average of 4 (range 2.4 to 10) years. METHODS: In this retrospective study, all patients had an active MRI scan at entry with a minimum of two new contrast enhancing lesions (CEL) on baseline MRI examinations. Patients were followed for a minimum of 3 months during a baseline (pretreatment) phase and subsequently followed during treatment with recombinant interferon beta (IFN) and various other immunomodulatory agents. Pre- and post contrast axial images were obtained using 3-mm slice thickness and a gadolinium contrast dose of 0.1 mmol/kg. Monthly CEL were sequentially numbered on hardcopy films and monthly BFV was determined on precontrast T1W images using a semiautomated program. For BFV measurements, all T1W scans were registered to the entry examination, which served as a mask image. Cerebral atrophy was measured as percent brain fractional volume change (PBVC) compared to the entry baseline scan. RESULTS: The results demonstrate that cerebral atrophy paralleled that of contrast enhancing lesion accumulation. The correlation between cumulative CEL and PBVC ranged from R2 = 0.47 to 0.81. Immunomodulatory agents that effectively reduced CEL accumulation also slowed the rate of atrophy. CONCLUSIONS: The correlation between contrast enhancing lesions (CEL) and atrophy suggests that patients who are not responding to therapy with a decrease in CEL may also be at risk for developing increased atrophy.
OBJECTIVE: To investigate the temporal relationship between inflammation and cerebral atrophy in a longitudinal study of 19 patients with relapsing-remitting multiple sclerosis (RRMS) using serial monthly contrast enhanced MRI examinations and monthly measurements of brain fractional volume (BFV) for an average of 4 (range 2.4 to 10) years. METHODS: In this retrospective study, all patients had an active MRI scan at entry with a minimum of two new contrast enhancing lesions (CEL) on baseline MRI examinations. Patients were followed for a minimum of 3 months during a baseline (pretreatment) phase and subsequently followed during treatment with recombinant interferon beta (IFN) and various other immunomodulatory agents. Pre- and post contrast axial images were obtained using 3-mm slice thickness and a gadolinium contrast dose of 0.1 mmol/kg. Monthly CEL were sequentially numbered on hardcopy films and monthly BFV was determined on precontrast T1W images using a semiautomated program. For BFV measurements, all T1W scans were registered to the entry examination, which served as a mask image. Cerebral atrophy was measured as percent brain fractional volume change (PBVC) compared to the entry baseline scan. RESULTS: The results demonstrate that cerebral atrophy paralleled that of contrast enhancing lesion accumulation. The correlation between cumulative CEL and PBVC ranged from R2 = 0.47 to 0.81. Immunomodulatory agents that effectively reduced CEL accumulation also slowed the rate of atrophy. CONCLUSIONS: The correlation between contrast enhancing lesions (CEL) and atrophy suggests that patients who are not responding to therapy with a decrease in CEL may also be at risk for developing increased atrophy.
Authors: B Bielekova; N Richert; M L Herman; J Ohayon; T A Waldmann; H McFarland; R Martin; G Blevins Journal: Neurology Date: 2011-11-09 Impact factor: 9.910
Authors: Kerstin Bendfeldt; Bernd Taschler; Laura Gaetano; Philip Madoerin; Pascal Kuster; Nicole Mueller-Lenke; Michael Amann; Hugo Vrenken; Viktor Wottschel; Frederik Barkhof; Stefan Borgwardt; Stefan Klöppel; Eva-Maria Wicklein; Ludwig Kappos; Gilles Edan; Mark S Freedman; Xavier Montalbán; Hans-Peter Hartung; Christoph Pohl; Rupert Sandbrink; Till Sprenger; Ernst-Wilhelm Radue; Jens Wuerfel; Thomas E Nichols Journal: Brain Imaging Behav Date: 2019-10 Impact factor: 3.978
Authors: Bibiana Bielekova; Nancy Richert; Thomas Howard; Amy N Packer; Gregg Blevins; Joan Ohayon; Henry F McFarland; Claus-Steffen Stürzebecher; Roland Martin Journal: Mult Scler Date: 2009-09-23 Impact factor: 6.312
Authors: Nicola De Stefano; Maria Laura Stromillo; Antonio Giorgio; Maria Letizia Bartolozzi; Marco Battaglini; Mariella Baldini; Emilio Portaccio; Maria Pia Amato; Maria Pia Sormani Journal: J Neurol Neurosurg Psychiatry Date: 2015-04-22 Impact factor: 10.154