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Updated: May 29, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Effect of disease-modifying therapies on brain volume in relapsing-remitting multiple sclerosis: results of a
Omar Khan1, Fen Bao, Megha Shah
1MR Image Analysis Laboratory, Department of Neurology, Wayne State University School of Medicine, Detroit, MI 48201, USA. okhan@med.wayne.edu
Objective:
To compare the long-term effect of disease-modifying therapies (DMT) on brain volume loss in relapsing-remitting MS (RRMS) patients.
Methods:
We conducted a study to examine the effect of daily glatiramer acetate (GA), weekly low dose interferon beta (LD-IFNB), and high-dose high-frequency interferon beta disease (HD-IFNB) on brain volume loss over 5 years in RRMS patients. All patients were previously treatment naïve, had disease duration ≤5 years at the time of initiating DMT, and subsequently received the same DMT for 5 years continuously. The percentage change in brain volume (PCBV) was measured using fully automated software. MRI analysis was performed blinded to treatment allocation.
Results:
The adjusted PCBV from baseline to year 5 was -2.27% in GA, -2.62% in LD-IFNB, and -3.21% in the HD-IFNB groups (-2.27 vs -2.62, p=0.0036; -2.27 vs -3.21, p<0.0001; -2.62 vs -3.21, p<0.0001). These data remained unchanged from year 1 to year 5, after adjusting for pseudoatrophy in the first year. A group of RRMS patients that remained untreated for a period ranging from 8 to 24 months, served as controls. All treatment groups were significantly better than the rate of projected brain volume loss in the untreated group over 5 years (p<0.0001).
Conclusions:
Global brain volume loss is a dynamic process even in relatively early RRMS patients that occurs despite intervention with therapy. However, all DMT significantly reduced the loss of brain volume compared to no treatment. The GA-treated group experienced the least reduction in brain volume over 5 years, compared to the LD-IFNB and HD-IFNB treated groups. These differences could be partly related to the immunologic consequences of GA therapy in RRMS.
Insights
Disease-modifying therapies (DMT) for relapsing-remitting MS (RRMS) slow brain volume loss. Glatiramer acetate (GA) showed the least brain volume reduction over 5 years compared to interferon beta therapies, indicating DMT effectiveness in managing MS progression.
Area of Science:
- Neuroscience
- Immunology
- Radiology
Background:
- Relapsing-remitting multiple sclerosis (RRMS) is characterized by unpredictable attacks.
- Brain volume loss is a key indicator of disease progression in MS.
- Disease-modifying therapies (DMT) aim to reduce the frequency and severity of relapses and slow disability progression.
Purpose of the Study:
- To compare the long-term (5-year) effects of glatiramer acetate (GA), low-dose interferon beta (LD-IFNB), and high-dose interferon beta (HD-IFNB) on brain volume loss in RRMS patients.
- To assess the efficacy of these DMTs in mitigating neurodegeneration.
- To evaluate the rate of brain volume change in treated RRMS patients versus an untreated control group.
Main Methods:
- A 5-year prospective study involving treatment-naïve RRMS patients with recent disease onset (≤5 years).
- Patients received continuous daily GA, weekly LD-IFNB, or HD-IFNB.
- Brain volume changes were quantified using automated software and MRI analysis blinded to treatment allocation.
Main Results:
- All DMT groups demonstrated significantly less brain volume loss compared to the untreated control group over 5 years (p<0.0001).
- The adjusted percentage brain volume change from baseline to year 5 was -2.27% for GA, -2.62% for LD-IFNB, and -3.21% for HD-IFNB.
- Glatiramer acetate (GA) treatment resulted in the least brain volume reduction compared to both LD-IFNB and HD-IFNB groups (p<0.0001).
Conclusions:
- Global brain volume loss is a continuous process in early RRMS, even with DMT intervention.
- All evaluated DMTs significantly reduce brain volume loss compared to no treatment.
- Glatiramer acetate (GA) demonstrated a superior effect in preserving brain volume over 5 years compared to interferon beta therapies, potentially due to its immunomodulatory mechanisms.
Related Concept Videos
01:19Multiple Sclerosis l: Introduction
01:27Imaging Studies IV: Magnetic Resonance Imaging
01:14Brain Imaging
These technologies include computerized axial tomography (CAT or CT scans), positron-emission tomography (PET scans), magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), and Transcranial Magnetic Stimulation (TMS).