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MRI changes in multiple sclerosis following treatment with lofepramine and L-phenylalanine
B K Puri1, G M Bydder, K R Chaudhuri
1Magnetic Resonance Unit, MRC Clinical Sciences Centre, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK.
Abstract:
As part of a large, randomized placebo-controlled trial of inpatients with multiple sclerosis (MS), a subsample of 15 underwent cerebral MRI at baseline and 6-months (eight on lofepramine and l-phenylalanine; seven on placebo). Unlike the placebo group, the active group showed a significant reduction in lesion number visible on T1-weighted scans (p < 0.05). The lateral ventricular volume increased, on average, by 1020 mm3 in the untreated group and 600 mm3 in the treated group. In the treated patients the ventricular size change correlated with both change in Gulick MS-related symptoms scale scores (rs = 0.71, p = 0.07) and Gulick MS-related activities of daily living scale scores (rs = -0.83, p = 0.02). It is concluded that treatment with lofepramine and l-phenylalanine is associated with significant MRI changes.
Insights
Lofepramine and l-phenylalanine treatment in multiple sclerosis (MS) patients significantly reduced MRI-detected lesions and slowed ventricular enlargement. These changes correlated with improved symptom and daily living scores.
Area of Science:
- Neurology
- Radiology
- Pharmacology
Background:
- Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system.
- Magnetic Resonance Imaging (MRI) is crucial for monitoring MS progression and treatment efficacy.
- Identifying effective treatments to slow MS-related brain changes is a key research area.
Purpose of the Study:
- To investigate the effects of lofepramine and l-phenylalanine on brain changes in multiple sclerosis (MS) patients using MRI.
- To assess the correlation between MRI findings and clinical outcomes in treated MS patients.
Main Methods:
- A subsample of 15 inpatients with MS from a randomized placebo-controlled trial underwent cerebral MRI at baseline and 6 months.
- Eight patients received lofepramine and l-phenylalanine, while seven received a placebo.
- T1-weighted MRI scans were analyzed for lesion number and lateral ventricular volume.
Main Results:
- The active treatment group showed a significant reduction in T1-weighted MRI lesion number compared to the placebo group (p < 0.05).
- Lateral ventricular volume increased less in the treated group (600 mm3) than in the placebo group (1020 mm3).
- In treated patients, changes in ventricular size correlated with changes in Gulick MS-related symptoms and activities of daily living scores.
Conclusions:
- Treatment with lofepramine and l-phenylalanine is associated with significant, positive changes in brain MRI metrics in MS patients.
- These MRI changes suggest a potential disease-modifying effect of the treatment.
- The findings support further investigation into lofepramine and l-phenylalanine as therapeutic agents for MS.