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From the Neuroimaging Research Unit, Departments of Neuroscience (Drs. Inglese, Rovaris, and Filippi) and Neurology (Dr. Comi), Scientific Institute and University Ospedale San Raffaele, Milan, Italy; MR–MS Centre (Drs. van Waesberghe, Barkhof, and Polman), VU Medical Centre, Amsterdam, the Netherlands; Schering AG (Dr. Wagner and K. Beckmann), Berlin, Germany; Institut für Röntgendiagnostik (Dr. Hahn), University of Wurzburg, Germany; Department of Neurology (Dr. Kappos), University Hospitals, Kantonsspital, Basel, Switzerland; NMR Research Unit (Drs. Miller and Thompson), Institute of Neurology, London, UK; Clinica Neurologica I (Dr. Pozzilli), Università La Sapienza, Rome, Italy; and Department of Neuroradiology (Dr. Yousry), Klinikum Grosshadern, Munich, Germany.
Address correspondence and reprint requests to Dr. Massimo Filippi, Neuroimaging Research Unit, Department of Neuroscience, Scientific Institute and University Ospedale San Raffaele, Via Olgettina, 60, 20132 Milan, Italy; e-mail address: filippi.massimo{at}hsr.it
Background: Magnetization transfer (MT) MRI can provide in vivo markers reflecting the severity of irreversible, MS-related brain damage occurring within and outside T2-visible lesions.
Objective: To assess the effect of interferon (IFN) ß-1b treatment on the accumulation of brain damage in patients with secondary progressive (SP) MS, measured using MT MRI.
Methods: Eighty-two patients with SPMS from five centers participating in a European, multicenter, double-blind, placebo-controlled trial of IFNß-1b in SPMS underwent brain T2-weighted and MT MRI at baseline. Evaluable follow-up data were available for 75 patients at 12 months, 54 at 24 months, and 47 at 36 months. MT MRI scans were postprocessed and analyzed to obtain histograms of MT ratio (MTR) values from the whole brain. A region of interest–based analysis of MTR values from the normal-appearing white matter (NAWM) was also performed.
Results: In both the treatment arms, there was a decrease of average brain MTR values from baseline to month 24 (mean change -4.9%) and month 36 (mean change -4.3%). These changes were significant for the placebo group at both timepoints and for the IFNß-1b group at month 24 only, with no significant treatment effect. A decrease of NAWM MTR was also observed, with no significant difference between the two treatment arms.
Conclusion: In this cohort of patients with secondary progressive MS, interferon ß-1b did not show an overall effect on the worsening of magnetization transfer MRI measures, when compared with placebo. The data show that change in magnetization transfer ratio is a promising tool for monitoring disease evolution in secondary progressive MS and that the information obtained from magnetization transfer MRI complements that obtained from MRI measures of lesion load and inflammation.
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