Objective: To determine the time course of brain atrophy during treatment with once- weekly IM interferon β - 1a (IFNβ - 1a). Methods: The MRI cohort (n = 386) of the European IFNβ - 1a dose comparison study in rel...Objective: To determine the time course of brain atrophy during treatment with once- weekly IM interferon β - 1a (IFNβ - 1a). Methods: The MRI cohort (n = 386) of the European IFNβ - 1a dose comparison study in relapsing multiple sclerosis (MS)- was analyzed. In addition to baseline and three annual scans, a frequent subgroup (n = 138) had two scans before treatment initiation and scans at months 4, 5, 6, 10, and 11. Brain parenchymal fraction (BPF), a normalized measure of whole- brain atrophy, and volume of Gd- enhancing lesions (T1Gd) and T2 hyperintense lesions (T2LL) were evaluated. Results: BPF decrease was - 0.686% (first year), - 0.377% (second year), and - 0.378% (third year). Analysis of the frequent subgroup showed that 68% of the first- year BPF decrease occurred during the first 4 months of treatment. This change was paralleled by a drop in T1Gd and T2LL. In the frequent subgroup, an annualized atrophy rate was determined by a regression slope for the pretreatment period and from month 4 of treatment onward. Annualized pretreatment rate (- 1.06% ) was significantly higher than the under- treatment rate (- 0.33% ). Conclusions: In the first year of treatment with anti- inflammatory agents, atrophy measurements are possibly confounded by resolution of inflammatory edema or more remote effects of previous damage to the CNS. The atrophy rate reduction observed after treatment month 4 may reflect a beneficial but partial effect of interferon β - 1a and was sustained over the 3- year study period.展开更多
文摘Objective: To determine the time course of brain atrophy during treatment with once- weekly IM interferon β - 1a (IFNβ - 1a). Methods: The MRI cohort (n = 386) of the European IFNβ - 1a dose comparison study in relapsing multiple sclerosis (MS)- was analyzed. In addition to baseline and three annual scans, a frequent subgroup (n = 138) had two scans before treatment initiation and scans at months 4, 5, 6, 10, and 11. Brain parenchymal fraction (BPF), a normalized measure of whole- brain atrophy, and volume of Gd- enhancing lesions (T1Gd) and T2 hyperintense lesions (T2LL) were evaluated. Results: BPF decrease was - 0.686% (first year), - 0.377% (second year), and - 0.378% (third year). Analysis of the frequent subgroup showed that 68% of the first- year BPF decrease occurred during the first 4 months of treatment. This change was paralleled by a drop in T1Gd and T2LL. In the frequent subgroup, an annualized atrophy rate was determined by a regression slope for the pretreatment period and from month 4 of treatment onward. Annualized pretreatment rate (- 1.06% ) was significantly higher than the under- treatment rate (- 0.33% ). Conclusions: In the first year of treatment with anti- inflammatory agents, atrophy measurements are possibly confounded by resolution of inflammatory edema or more remote effects of previous damage to the CNS. The atrophy rate reduction observed after treatment month 4 may reflect a beneficial but partial effect of interferon β - 1a and was sustained over the 3- year study period.
