- Title
- Neurometabolic changes in multiple sclerosis: Fingolimod versus beta interferon or glatiramer acetate therapy
- Creator
- Al-iedani, Oun; Lea, Rodney; Ribbons, Karen; Ramadan, Saadallah; Lechner-Scott, Jeannette
- Relation
- Journal of Neuroimaging Vol. 32, Issue 6, p. 1109-1120
- Publisher Link
- http://dx.doi.org/10.1111/jon.13032
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2022
- Description
- Background and Purpose: Fingolimod has been shown to be more effective in reducing relapse rate and disability than injectable therapies in clinical trials. An increase in N-acetylaspartate (NAA) as measured by MR spectroscopy is correlated with maintaining axonal metabolic functions. This study compared the neurometabolic and volumetric changes in relapsing-remitting multiple sclerosis (RRMS) patients on fingolimod or injectable therapies with healthy controls (HCs). Methods: Ninety-eight RRMS (52 on fingolimod, 46 on injectable therapies (27 on glatiramer acetate and 19 on interferon) were age and sex-matched to 51 HCs. RRMS patients underwent cognitive, fatigue, and mental health assessments, as well as an Expanded disability status scale (EDSS). MRI/S was acquired from the hippocampus, posterior cingulate gyrus (PCG), and prefrontal cortex (PFC). Volumetric and neurometabolic measures were compared across cohorts using a univariate general linear model and correlated with clinical severity and neuropsychological scores. Results: Clinical parameters, MR-volumetric, and neurometabolic profiles showed no differences between treatment groups (p >.05). Compared to HCs, both RRMS cohorts showed volume changes in white matter (−13%), gray matter (−16%), and cerebral spinal fluid (CSF) (+17-23%), as well as reduced NAA (−17%, p =.001, hippocampus), (−7%, p =.001, PCG), and (−9%, p =.001, PFC). MRI/S metrics in three regions were moderately correlated with cognition and fatigue functions. Conclusion: While both treatment arms showed overall similar volumetric and neurometabolic profiles, longitudinal studies are warranted to clarify neurometabolic changes and associations with treatment efficacy.
- Subject
- fingolimod and injectables therapies; MRI; MRS; multiple sclerosis; neurometabolites
- Identifier
- http://hdl.handle.net/1959.13/1492325
- Identifier
- uon:53309
- Identifier
- ISSN:1051-2284
- Language
- eng
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