Glatiramer acetate recovers microscopic tissue damage in patients with multiple sclerosis. A case-control diffusion...

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• Traditional MRI is limited in detecting neuronal damage in multiple sclerosis (MS).
• Advanced MRI metrics offer insights into microscopic neuronal changes, but their response to MS therapies is understudied.
• Diffusion-weighted imaging (DWI) shows promise for assessing subtle brain tissue alterations.

Purpose of the Study:

• To evaluate the effect of subcutaneous glatiramer acetate (GA) 20mg/day on 1- and 2-year changes in DWI measures in relapsing-remitting MS (RRMS) patients.
• To compare DWI changes in GA-treated RRMS patients with age- and sex-matched healthy controls (HC).

Main Methods:

• Prospective, open-label, observational study.
• 1.5T MRI scans and clinical examinations at baseline, 1 year, and 2 years.
• Inclusion criteria: RRMS, age 18-65, EDSS ≤5.5, disease duration <20 years.

Main Results:

• GA treatment promoted recovery of DWI mean parenchymal diffusivity (MPD) in MS patients at year 1 (-7.1%) and year 2 (-10.1%).
• DWI MPD recovery was significantly higher in MS patients compared to HC at both 1 year (p=0.01) and 2 years (p<0.001).
• GA also promoted recovery of DWI entropy at 2 years (-1.2%, p=0.018) in MS patients; no significant changes observed in HC.
• No significant changes in magnetization transfer ratio or global/regional atrophy were observed in either group over 2 years.

Conclusions:

• Subcutaneous glatiramer acetate (GA) 20mg/day significantly improved microscopic brain tissue damage in RRMS patients over 2 years, as measured by DWI.
• DWI metrics, particularly MPD, are sensitive to the therapeutic effects of GA on neuronal integrity in MS.
• GA demonstrates a positive impact on brain microstructure without inducing significant atrophy or changes in MTR.