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MRI brain volume changes in relapsing-remitting multiple sclerosis patients treated with interferon beta-1a

Department of Neuroscience, S. Camillo-Forlanini Hospital, Rome, Italy, c.gasperini{at}libero.it

A Paolillo

Department of Neurological Sciences, University of Rome ‘La Sapienza’, Rome, Italy

E Giugni

Department of Neurological Sciences, University of Rome ‘La Sapienza’, Rome, Italy

S Galgani

Department of Neuroscience, S. Camillo-Forlanini Hospital, Rome, Italy

F Bagnato

Department of Neurological Sciences, University of Rome ‘La Sapienza’, Rome, Italy

C Mainero

Department of Neurological Sciences, University of Rome ‘La Sapienza’, Rome, Italy

E Onesti

Department of Neurological Sciences, University of Rome ‘La Sapienza’, Rome, Italy

S Bastianello

Neuroradiological Unit, Department of Neurological Sciences, University of Rome ‘La Sapienza’, Rome, Italy

C Pozzilli

Department of Neurological Sciences, University of Rome ‘La Sapienza’, Rome, Italy

The aim of this study was to investigate changes of brain volume as measured by magnetic resonance imaging (MRI) in relapsing-remitting multiple sclerosis (MS) patients under treatment with interferon beta-1a. Moreover, the relationship between brain volume changes and standard MR or clinical outcome variables was determined. After a 6-month pretreatment period, 52 patients with relapsing-remitting MS were assigned to receive interferon beta-1a (Rebif-Serono) during a 24-month treatment period. MRI scans were performed monthly during the 6-month pretreatment period and for the first 9 months of the treatment period. A final MRI scan was also performed at the end of the 12- and 24-month treatment period. Over 24 months of IFNß-1a treatment, a significant decrease of hyperintense lesion volume was found (–18.0%; p<0.0001) compared to the last pretreatment scan, while T1 hypointense volume showed a slight nonsignificant increase (+2.2%), and brain volume showed a significant decrease (–2.2%; p<0.0001). The mean volume of enhancing lesions over the 6-month pretreatment period was significantly related to absolute (p=0.02; r=–0.32) and per cent change (p=0.03; r=–0.30) of brain volume during 24-month treatment period. No correlations between changes in brain volume and changes in T2 hyperintense volume or T1 hypointense volume were observed. Neither was there a relationship between brain volume and changes of Expanded Disability Status Scale (EDSS) or frequency in clinical relapses. Of the group in whom was detected a significant decrease of brain volume, 13 out of 26 (50%) had a sustained change in EDSS while in the group that did not have a significant decrease of brain volume, only 3 out of 26 (11.5%) had a sustained EDSS change (p=0.02). In this study a decrease of brain volume was found in relapsing-remitting MS patients treated with IFNß-1a over 2 years. The only parameter that predicted brain volume decrease by 2 years of IFNß-1a treatment was the mean volume of enhancing lesions over the 6-month pretreatment period.

Key Words: brain atrophy • magnetic resonance imaging • multiple sclerosis

Multiple Sclerosis, Vol. 8, No. 2, 119-123 (2002)
DOI: 10.1191/1352458502ms788oa


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