共 39 条
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
来源:
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
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页码:1868 / 1876
页数:9
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