This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective: To compare magnetization transfer changes in new brain MRI lesions identified during monthly imaging in patients with multiple sclerosis (MS) randomized to treatment with 250 μg subcutaneous interferon-β-1b (IFN-β-1b) every other day or daily 20 mg glatiramer acetate (GA) in a post hoc study using data from the Betaseron Versus Copaxone for Relapsing Remitting or CIS Forms of MS Using Triple Dose Gad 3 T MRI (BECOME) trial.
Methods: T1-weighted images acquired with and without fat saturation pulses in the BECOME study were evaluated and found to exhibit magnetization transfer ratio (MTR) effects, and were used to compute MTR images (FSMTR). Forty-three participants who had the required imaging and new lesions, from the 75 originally randomized into the BECOME study, were included in this post hoc analysis and evaluated longitudinally during treatment to determine FSMTRDrop, an experimental measure of the completeness of FSMTR recovery in new lesions. Two sets of new brain MRI lesions were defined, one based on the appearance of gadolinium contrast enhancement (Gd lesions) and the other based on FSMTR decreases (ΔFSMTR lesions).
Results: A total of 887 Gd lesions were identified in 43 participants (19 GA, 24 IFN-β-1b) and 321 ΔFSMTR lesions in 32 participants (16 GA, 16 IFN-β-1b). Participants randomized to GA exhibited greater average postlesion FSMTR recovery than did those randomized to IFN-β-1b in both Gd (p < 0.0001) and ΔFSMTR (p < 0.0001) lesions.
Conclusions: New brain lesions that developed during treatment with GA exhibited evidence of greater FSMTR recovery than during treatment with IFN-β-1b.
Classification of evidence: This study provides Class III evidence that MTR recovery in patients with MS with new MRI brain lesions is greater with GA than with IFN-β-1b.
GLOSSARY
- BDNF=
- brain-derived neurotrophic factor;
- BECOME=
- Betaseron Versus Copaxone for Relapsing Remitting or CIS Forms of MS Using Triple Dose Gad 3 T MRI;
- CIS=
- clinically isolated syndrome;
- FS=
- fat saturation;
- FSMTR=
- fat saturation producing a magnetization transfer effect, used to create a fat saturation ratio image;
- GA=
- glatiramer acetate;
- Gd=
- gadolinium;
- IFN-β-1b=
- interferon-β-1b;
- LFB=
- Luxol fast blue;
- MS=
- multiple sclerosis;
- MTR=
- magnetization transfer ratio;
- NAWM=
- normal-appearing white matter;
- PD=
- proton density
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
- Received December 12, 2015.
- Accepted in final form May 17, 2016.
- © 2016 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Topics Discussed
Alert Me
Recommended articles
A magnetization transfer histogram study of normal-appearing brain tissue in MS
A conventional and magnetization transfer MRI study of the cervical cord in patients with MS
Comparison of MS clinical phenotypes using conventional and magnetization transfer MRI
Evidence for neuroprotection and remyelination using imaging techniques