Zivadinov Robert, Bergsland Niels, Carl Ellen, Ramasamy Deepa P, Hagemeier Jesper, Dwyer Michael G, Lizarraga Alexis A, Kolb Channa, Hojnacki David, Weinstock-Guttman Bianca
Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
J Clin Med. 2019 Mar 12;8(3):344. doi: 10.3390/jcm8030344.
Pathologic changes in cortical gray matter (GM) and leptomeninges contribute to disability worsening in patients with multiple sclerosis (MS), but there is little evidence whether disease-modifying treatments can slow down cortical pathology in MS. To investigate the effect of teriflunomide (TFM) and dimethyl fumarate (DMF) in reducing cortical pathology, as determined by percentage cortical volume change (PCVC) and leptomeningeal contrast enhancement (LMCE) on MRI. This was a retrospective, single-center, observational study that selected 60 TFM- and 60 DMF-treated MS patients over 24 months. TFM had a lower rate of PCVC compared to DMF over 24 months (-0.2% vs. -2.94%, = 0.004). Similar results were observed for percentage GM volume change over 0⁻12 ( = 0.044) and 0⁻24 (-0.44% vs. -3.12%, = 0.015) months. No significant differences were found between the TFM and DMF groups in the frequency and number of LMCE foci over the follow-up. TFM showed a numerically lower rate of whole brain atrophy over 24 months ( = 0.077), compared to DMF. No significant clinical or MRI lesion differences between TFM and DMF were detected over follow-up. These findings suggest that TFM has a superior effect on the preservation of cortical GM volume, compared to DMF.
皮质灰质（GM）和软脑膜的病理变化会导致多发性硬化症（MS）患者的残疾情况恶化，但几乎没有证据表明疾病修正治疗能否减缓MS患者的皮质病理变化。为了研究特立氟胺（TFM）和富马酸二甲酯（DMF）在减少皮质病理变化方面的效果，通过MRI上的皮质体积变化百分比（PCVC）和软脑膜对比增强（LMCE）来确定。这是一项回顾性、单中心观察性研究，选取了60例接受TFM治疗和60例接受DMF治疗超过24个月的MS患者。在24个月内，TFM的PCVC率低于DMF（-0.2%对-2.94%，P = 0.004）。在0至12个月（P = 0.044）和0至24个月（-0.44%对-3.12%，P = 0.015）时，GM体积变化百分比也观察到了类似结果。在随访期间，TFM组和DMF组在LMCE病灶的频率和数量上没有显著差异。与DMF相比，TFM在24个月内的全脑萎缩率在数值上较低（P = 0.077）。在随访期间，未检测到TFM和DMF之间存在显著的临床或MRI病灶差异。这些发现表明，与DMF相比，TFM在保留皮质GM体积方面具有更好的效果。
