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复发次数和疾病修正药物的早期干预与多发性硬化症患者脑萎缩进展程度较低有关。

Relapse numbers and earlier intervention by disease modifying drugs are related with progression of less brain atrophy in patients with multiple sclerosis.

机构信息

Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan.

Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan.

出版信息

J Neurol Sci. 2019 Aug 15;403:78-84. doi: 10.1016/j.jns.2019.06.011. Epub 2019 Jun 10.

DOI:10.1016/j.jns.2019.06.011
PMID:31233973
Abstract

Long term effect between disease-modifying drugs (DMDs) treatment duration and brain atrophy rate has not been fully investigated in patients with relapsing-remitting MS (RRMS). The aim of this study was to investigate whether DMDs could slow down the progression of brain atrophy in patients with RRMS by comparing DMDs-treated group with non-treated group during a certain period of time. This was a retrospective investigation. Forty-nine RRMS patients underwent two brain MRI scans more than one year apart. Between scans, patients were treated with fingolimod (n = 16), interferon-beta (n = 23) or not treated with DMD (n = 10). Correlations between clinical characteristics and brain volume were calculated by statistical parametric mapping-12. In all 49 patients, the total attack number before 1st MRI scan and the annualized rate of total lesion volume change between the two scans showed a positive correlation with annualized atrophy rate of grey matter volume (GMV) plus white matter volume (WMV). In patients with DMDs (n = 39), the period from drug initiation to 1st MRI scan was negatively correlated with the annualized atrophy rate of GMV + WMV and number of attacks between scans. The number of total previous attacks could be a predictor of subsequent MS progression. Early intervention by DMDs could prevent brain atrophy in patients with MS.

摘要

在复发缓解型多发性硬化症(RRMS)患者中,疾病修正治疗(DMD)的治疗持续时间与脑萎缩率之间的长期影响尚未得到充分研究。本研究的目的是通过比较 DMD 治疗组和未治疗组在特定时间段内的脑萎缩进展情况,来探讨 DMD 是否可以减缓 RRMS 患者的脑萎缩进展。这是一项回顾性研究。49 例 RRMS 患者在两次脑 MRI 扫描之间至少相隔一年。在扫描期间,患者接受了芬戈莫德(n=16)、干扰素-β(n=23)或未接受 DMD 治疗(n=10)。通过统计参数映射-12 计算临床特征与脑容量之间的相关性。在所有 49 例患者中,首次 MRI 扫描前的总发作次数和两次扫描之间的总病变体积变化的年化率与灰质体积(GMV)加白质体积(WMV)的年化萎缩率呈正相关。在接受 DMD 治疗的患者(n=39)中,从药物开始到首次 MRI 扫描的时间与 GMV+WMV 的年化萎缩率以及两次扫描之间的发作次数呈负相关。总的先前发作次数可能是后续 MS 进展的预测因素。早期 DMD 干预可预防 MS 患者的脑萎缩。

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