Rovaris Marco, Comi Giancarlo, Filippi Massimo
Neuroimaging Research Unit, Department of Neurology, Scientific Institute and University Ospedale San Raffaele, via Olgettina 60-20132 Milan, Italy.
J Neurol Sci. 2005 Jun 15;233(1-2):139-43. doi: 10.1016/j.jns.2005.03.013. Epub 2005 Apr 20.
The assessment of brain volume changes on serial magnetic resonance imaging (MRI) scans can provide an objective measure of progressive atrophy reflecting the neurodegenerative aspects of multiple sclerosis (MS) pathology. The present article reviews the results of studies assessing the effect of glatiramer acetate (GA) treatment in preventing MS-related, MRI-measurable brain volume decrease. Whilst data from the extended, open-label follow-up of the US trial seem to indicate that long-term treatment with GA might prevent the loss of brain parenchyma in relapsing-remitting MS patients, longitudinal data from the European/Canadian MRI trial suggest that, over a short-term period of treatment, GA does not have a clear-cut impact on the decrease of brain volume. The effect of GA on MS-related brain atrophy might, therefore, be delayed and dissociated in time from those exerted on other clinical and MRI measures of disease activity. However, the modest magnitude of this effect makes it difficult to evaluate its impact on the actual disease progression. Further studies of adequate duration are now required to address this issue, as well as to confirm the sustained efficacy of GA treatment over long periods of follow-up.
通过系列磁共振成像（MRI）扫描评估脑容量变化，可提供反映多发性硬化症（MS）病理神经退行性方面的进行性萎缩的客观指标。本文综述了评估醋酸格拉替雷（GA）治疗对预防MS相关、MRI可测量的脑容量减少效果的研究结果。美国试验的长期开放标签随访数据似乎表明，GA长期治疗可能预防复发缓解型MS患者脑实质的丢失，而欧洲/加拿大MRI试验的纵向数据表明，在短期治疗期间，GA对脑容量减少没有明确影响。因此，GA对MS相关脑萎缩的作用可能会延迟，且在时间上与对疾病活动的其他临床和MRI指标的作用相分离。然而，这种作用的程度较小，难以评估其对实际疾病进展的影响。现在需要进行足够时长的进一步研究来解决这个问题，以及确认GA治疗在长期随访中的持续疗效。
