Gray and white matter brain pathology in highly active multiple sclerosis patients

SANCHEZ FRANCISCO; MIGUEZ, JIMENA; PATRUCCO LILIANA; ROJAS JUAN IGNACIO; CRISTIANO EDGARDO

Berlin

Congreso; 34TH Congress of the European Comitee for Treatment and Research in Multiple Sclerosis (ECTRIMS); 2018

European Comitee for Treatment and Research in Multiple Sclerosis (ECTRIMS)

bstract: EP1504Type: Poster SessionsAbstract Category: Pathology and pathogenesis of MS - MRI and PETThe objective of the study was to analyze white matter (WM) and gray matter (GM) pathology in highly active MS (HAMS) vs. no-HAMS patients. Methods: we included patients with MS older than 18 years and with at least 2 years of follow up. HAMS was defined as patients with 1 relapse in the previous year and at least 1 T1 Gd+ lesion or 9 or more T2 lesions, while on therapy with other DMDs, or patients with 2 or more relapses in the previous year, whether on DMD treatment or not. Only patients naïve to previous treatment were included. High-resolution T1-3D weighted MRI scans were acquired at baseline and every 12 months for 2 years. Brain volume measures were determined on 3D T1-WI. At baseline, whole brain, GM and WM tissue volumes, were calculated using the SIENAX method, whereas for longitudinal changes, the SIENA method was used to calculate the percentage brain volume change (PBVC), and the SIENAX multi-time point method was used to obtain GM volume and WM volume changes. Between-group differences of volume analysis were assessed by logistic regression analysis (p < 0.05 significant). Results: 64 patients, mean age 38.4 years, 35 (57%) women were included. A total of 14 (21%) were classified as HAMS. At baseline, HAMS patients showed lower GM and WM volume compared with no-HAMS (p=0.001 and p=0.01 respectively). All patients received fingolimod to treat their disease. During the follow up, HAMS showed a higher decrease in the percent of gray matter volume change compared with no-HAMS (-0.61 vs. - 0.77 p< 0.001) but a similar percent of white matter change between groups were found (-0.43 vs. -0.50 p=0.04). Conclusion: HAMS patients developed similar rates of WM but different rates of GM atrophy over 24 months, compared to non-HAMS patients.Disclosure: The study was done without external support Code of conduct/disclaimer available in General Terms & Conditions