Assessing brain atrophy rates in a large population of untreated multiple sclerosis subtypes

被引:258
作者
De Stefano, N. [1 ]
Giorgio, A. [10 ]
Battaglini, M.
Rovaris, M. [2 ,3 ]
Sormani, M. P. [4 ]
Barkhof, F. [5 ]
Korteweg, T. [5 ]
Enzinger, C. [6 ]
Fazekas, F. [6 ]
Calabrese, M. [7 ]
Dinacci, D. [8 ,9 ]
Tedeschi, G. [8 ,9 ]
Gass, A.
Montalban, X. [11 ]
Rovira, A. [11 ]
Thompson, A. [12 ]
Comi, G. [3 ,13 ]
Miller, D. H. [14 ]
Filippi, M. [2 ,3 ]
机构
[1] Univ Siena, Quantitat Neuroimaging Lab, Dept Neurol & Behav Sci, I-53100 Siena, Italy
[2] Inst Sci, Inst Expt Neurol, Div Neurosci, Neuroimaging Res Unit, Milan, Italy
[3] Univ Osped San Raffaele, Milan, Italy
[4] Univ Genoa, Dept Hlth Sci, Biostat Unit, Genoa, Italy
[5] Vrije Univ Amsterdam, Med Ctr, Dept Radiol, Amsterdam, Netherlands
[6] Med Univ Graz, Dept Neurol, Graz, Austria
[7] Univ Hosp Padua, Dept Neurosci, Neurol Clin 1, Multiple Sclerosis Ctr Veneto Reg, Padua, Italy
[8] Univ Naples 2, Dept Neurol Sci, Naples, Italy
[9] Inst Hermitage Capodimonte, Naples, Italy
[10] Kantonsspital, Univ Hosp, Dept Neurol, CH-4031 Basel, Switzerland
[11] Hosp Valle De Hebron, Dept Neuroimmunol & Radiol, Barcelona, Spain
[12] UCL, Inst Neurol, Dept Brain Repair & Rehabil, London, England
[13] Inst Sci, Inst Expt Neurol, Div Neurosci, Dept Neurol, Milan, Italy
[14] UCL, Inst Neurol, Dept Neuroinflammat, London, England
关键词
TERM-FOLLOW-UP; GLATIRAMER ACETATE; CEREBRAL ATROPHY; VOLUME CHANGES; DOUBLE-BLIND; PROGRESSIVE MS; INTRAVENOUS IMMUNOGLOBULIN; DISEASE-ACTIVITY; MRI; MULTICENTER;
D O I
10.1212/WNL.0b013e3181e24136
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: To assess the time course of brain atrophy and the difference across clinical subtypes in multiple sclerosis (MS). Methods: The percent brain volume change (PBVC) was computed on existing longitudinal (2 time points) T1-weighted MRI from untreated (trial and nontrial) patients with MS. Patients (n = 963) were classified as clinically isolated syndromes suggestive of MS (CIS, 16%), relapsing-remitting (RR, 60%), secondary progressive (SP, 15%), and primary progressive (9%) MS. The median length of follow-up was 14 months (range 12-68). Results: There was marked heterogeneity of the annualized PBVC (PBVC/y) across MS subtypes (p = 0.003), with higher PBVC/y in SP than in CIS (p = 0.003). However, this heterogeneity disappeared when data were corrected for the baseline normalized brain volume. When the MS population was divided into trial and nontrial subjects, the heterogeneity of PBVC/y across MS subtypes was present only in the second group, due to the higher PBVC/y values found in trial data in CIS (p = 0.01) and RR (p < 0.001). The estimation of the sample sizes required for demonstrating a reduction of brain atrophy in patients in a placebo-controlled trial showed that this was larger in patients with early MS than in those with the progressive forms of the disease. Conclusions: This first large study in untreated patients with multiple sclerosis (MS) with different disease subtypes shows that brain atrophy proceeds relentlessly throughout the course of MS, with a rate that seems largely independent of the MS subtype, when adjusting for baseline brain volume. Neurology (R) 2010; 74: 1868-1876
引用
收藏
页码:1868 / 1876
页数:9
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