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The effect of interferon beta-1b on quantities derived from MT MRI in secondary progressive MS
M Inglese1, J H T M van Waesberghe, M Rovaris
1Neuroimaging Research Unit, Department of Neuroscience, Scientific Institute and University Ospedale San Raffaele, Milan, Italy.
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) beta-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 IFNbeta-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 IFNbeta-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 beta-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.
Insights
Interferon beta-1b did not significantly alter magnetization transfer MRI measures of brain damage in secondary progressive MS patients compared to placebo. Magnetization transfer ratio changes show promise for monitoring disease progression in SPMS.
Area of Science:
- Neuroimaging
- Neurology
- Medical Imaging
Background:
- Magnetization transfer (MT) MRI offers in vivo markers for irreversible brain damage in multiple sclerosis (MS).
- This damage occurs both within and outside of T2-visible lesions.
Purpose of the Study:
- To evaluate the impact of interferon (IFN) beta-1b treatment on brain damage accumulation in secondary progressive MS (SPMS) patients.
- Brain damage was assessed using MT MRI.
Main Methods:
- Eighty-two SPMS patients in a double-blind, placebo-controlled trial of IFNbeta-1b underwent baseline MT MRI.
- Follow-up MT MRI data were collected up to 36 months.
- Analysis included whole-brain MT ratio (MTR) histograms and MTR in normal-appearing white matter (NAWM).
Main Results:
- Average brain MTR decreased in both placebo and IFNbeta-1b groups from baseline to 36 months.
- The decrease was significant in the placebo group at 24 and 36 months, and in the IFNbeta-1b group at 24 months.
- No significant treatment effect was observed, and NAWM MTR also decreased similarly in both groups.
Conclusions:
- Interferon beta-1b did not demonstrate an overall effect on MT MRI measures of worsening brain damage in SPMS patients versus placebo.
- MT ratio changes are a promising tool for monitoring SPMS disease evolution.
- MT MRI provides complementary information to lesion load and inflammation MRI measures.
