MS Center Amsterdam, Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.
MS Center Amsterdam, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.
Mult Scler. 2024 Jan;30(1):44-54. doi: 10.1177/13524585231212879. Epub 2023 Nov 29.
Whether the degree of inflammation (and its resolution) and neurodegeneration after treatment initiation predicts disease progression in multiple sclerosis (MS) remains unclear.
To assess the predictive value of magnetic resonance imaging (MRI)-derived brain and lesion volume (LV) changes in years 1 and 2 of treatment for disease progression.
Patients receiving early interferon beta-1a treatment in REFLEX/REFLEXION ( = 262) were included. Predictive regression models included new/enlarging LV (positive activity), disappearing/shrinking LV (negative activity), and global/central atrophy during years 1 and 2.
Faster global atrophy and/or pseudo-atrophy and positive lesion activity in years 1 and 2 related to an increased probability and faster conversion to clinically definite multiple sclerosis (CDMS). Negative lesion activity in year 1 and slower central atrophy in year 2 were predictive of confirmed disability progression (9-Hole Peg Test). Positive lesion activity in year 2 was predictive of faster global atrophy, while positive lesion activity in years 1 and 2 was predictive of faster central atrophy.
A higher degree of global atrophy and/or pseudo-atrophy in year 1 was predictive of CDMS. Positive lesion activity in any year was related to CDMS and neurodegeneration. Disability was related to negative lesion activity in year 1 and slower central atrophy in year 2.
治疗开始后炎症程度(及其消退)和神经退行性变是否可预测多发性硬化症(MS)的疾病进展尚不清楚。
评估治疗开始后 1 年和 2 年时磁共振成像(MRI)脑和病灶体积(LV)变化对疾病进展的预测价值。
纳入接受早期干扰素β-1a 治疗的 REFLEX/REFLEXION 研究中的患者(n=262)。预测回归模型包括第 1 年和第 2 年时新增大病灶(阳性活动)、病灶消失缩小(阴性活动)以及全脑/中央萎缩。
第 1 年更快的全脑萎缩和/或假性萎缩和阳性病灶活动与增加的临床确诊多发性硬化症(CDMS)的可能性和更快的转化相关。第 1 年阴性病灶活动和第 2 年较慢的中央萎缩与确诊残疾进展(9 孔插板测试)相关。第 2 年的阳性病灶活动与更快的全脑萎缩相关,而第 1 年和第 2 年的阳性病灶活动与更快的中央萎缩相关。
第 1 年更高的全脑萎缩和/或假性萎缩程度与 CDMS 相关。任何一年的阳性病灶活动与 CDMS 和神经退行性变相关。残疾与第 1 年的阴性病灶活动和第 2 年较慢的中央萎缩相关。