Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, NY, USA; Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, State University of New York, NY, USA.
Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, NY, USA.
J Neurol Sci. 2018 May 15;388:175-181. doi: 10.1016/j.jns.2018.03.028. Epub 2018 Mar 17.
To investigate the effect of teriflunomide on microstructural pathology in the gray matter (GM) and white matter (WM), as measured by changes in brain volume and diffusion-tensor imaging (DTI) in patients with multiple sclerosis (MS).
30 relapsing MS patients and 20 healthy controls (HCs) were enrolled in the study and followed prospectively for 12 months with clinical and 3T MRI examinations. Of those, 26 MS patients and 18 HCs completed the 6-month and 22 MS and 16 HCs patients the 12-month follow-up. Whole brain, GM, WM and thalamus volumes, and global and tract-based spatial statistics (TBSS) DTI measures of fractional anisotropy, mean, axial and radial diffusivity were obtained in the thalamus and normal appearing WM (NAWM). MRI differences between the groups were compared using non-parametric statistical methods due to sample size limitations, followed by post-hoc covariate-adjusted models.
At baseline, MS patients showed more severe brain volume and DTI measures compared to HCs (p < .05). At follow-up, no significant differences for brain volume and global and TBSS DTI measures between MS patients and HCs were found. No clinical progression or serious adverse events occurred in MS patients over the follow-up.
MS patients did not significantly deteriorate over the follow-up in brain volume or thalamus/NAWM global or TBSS DTI measures, compared to HCs. This suggests that treatment with teriflunomide could potentially slow down accumulation of microstructural tissue damage in the GM and NAWM.
研究特立氟胺对多发性硬化症（MS）患者脑体积和弥散张量成像（DTI）变化所测量的灰质（GM）和白质（WM）微观结构病理学的影响。
本研究前瞻性纳入 30 例复发型 MS 患者和 20 例健康对照者（HCs），并进行 12 个月的临床和 3T MRI 检查。其中，26 例 MS 患者和 18 例 HCs 完成了 6 个月随访，22 例 MS 患者和 16 例 HCs 完成了 12 个月随访。在丘脑和正常表现 WM（NAWM）中获得全脑、GM、WM 和丘脑体积以及整体和基于束的空间统计学（TBSS）各向异性分数、均值、轴向和径向弥散度的 DTI 测量值。由于样本量限制，使用非参数统计方法比较组间的 MRI 差异，然后进行协变量调整的事后模型。
基线时，MS 患者的脑体积和 DTI 测量值明显高于 HCs（p<0.05）。随访时，MS 患者和 HCs 之间的脑体积以及整体和 TBSS DTI 测量值无显著差异。在随访期间，MS 患者未发生临床进展或严重不良事件。
与 HCs 相比，MS 患者在脑体积或丘脑/NAWM 整体或 TBSS DTI 测量值方面在随访期间没有明显恶化。这表明特立氟胺治疗可能减缓 GM 和 NAWM 中微观结构组织损伤的积累。
