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Effect of dimethyl fumarate on gray and white matter pathology in subjects with relapsing multiple sclerosis: a

R Zivadinov1,2, J Hagemeier1, N Bergsland1

  • 1Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.

European Journal of Neurology
|January 10, 2018
PubMed
Abstract

Insights

Dimethyl fumarate (DMF) may protect against white matter and gray matter damage in multiple sclerosis (MS). This study found DMF-treated MS patients showed less diffusivity changes over 24 months compared to healthy individuals.

Area of Science:

  • Neuroscience
  • Radiology
  • Pharmacology

Background:

  • Relapsing-remitting multiple sclerosis (MS) is an inflammatory and neurodegenerative disease.
  • Dimethyl fumarate (DMF) is an oral immunomodulator used to treat MS.
  • The precise impact of DMF on white matter and gray matter pathology in MS remains incompletely understood.

Purpose of the Study:

  • To longitudinally characterize the effects of DMF on normal-appearing white matter (NAWM) and thalamic pathology in patients with MS.
  • To compare diffusion tensor imaging (DTI) metrics in the thalamus and NAWM between MS patients treated with DMF and healthy controls over 24 months.

Main Methods:

  • An observational, longitudinal 24-month magnetic resonance imaging (MRI) study.
  • Inclusion of 75 patients with relapsing-remitting MS treated with DMF and 40 age- and sex-matched healthy controls.
  • Assessment of regional DTI metrics (mean diffusivity, axial diffusivity, radial diffusivity, fractional anisotropy) in the thalamus and NAWM using tract-based spatial statistics.

Main Results:

  • At baseline, MS patients exhibited significantly higher diffusivity and lower fractional anisotropy in the thalamus and NAWM compared to healthy individuals.
  • No significant changes in DTI metrics were observed within either group over the 24-month study period.
  • Healthy individuals demonstrated a significantly greater increase in diffusivity parameters in the thalamus and NAWM over 24 months compared to MS patients.

Conclusions:

  • The stability of DTI metrics in MS patients treated with DMF over 24 months suggests a potential neuroprotective effect of the drug.
  • These findings support the beneficial role of DMF in mitigating MS-related white matter and gray matter pathology.
Keywords:
magnetic resonance imagingdiffusion tensor imaginghealthy individualsmultiple sclerosisnormal-appearing white matterthalamustract-based spatial statistics

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