Oral steriods cause Brain Atrophy.
Mult Scler 2002 Oct;8(5):415-9
Cerebral volume changes in multiple sclerosis patients treated with
high-dose intravenous methylprednisolone.
Hoogervorst EL, Polman CH, Barkhof F
Department of Neurology, VU Medical Center, Amsterdam, The
OBJECTIVE: Multiple sderosis (MS) patients develop varying degrees of
cerebral atrophy, which may already begin at disease onset The
purpose of this study is to examine the effect of steroid treatment
on cerebral volume in MS patients.
METHODS: Thirty-five MS patients
participating in a clinical trial of oral interferon beta, which
induded monthly MRI, were included in this study. They suffered from
an acute relapse and were treated with intravenous methylprednisolone
(IV-MP); 13 of the patients were treated with oral prednisolone
tapering after IV-MP. The last MRI scan before and the first (and
second for oral tapering patients) scan after IV-MP treatment were
used for measuring parenchymal fraction (PF) and ventricular fraction
(VF). Changes in PF and VF were analysed using Student's t test.
RESULTS: For the total population no significant changes in PF or VF
However, the subgroup of patients receiving oral tapering
after IV-MP showed changes, compatible with atrophy in both PF and
VF, that were significant immediately after IV-MP treatment and still
persisted (though not statistically significant anymore) after a mean
interval of 30 days. The magnitude of these changes was about the
same as the annual change in cerebral volume as reported in natural
CONCLUSION: Our data indicate that short courses of
intravenous steroids (restricted to three or five days) have no major
impact, [b]whereas prolonged treatment with oral tapering does
significantly affect brain volume. These findings are important for
longitudinal studies and clinical trials in which brain volume is
used as an outcome measure.[/b]
PMID: 12356209, UI: 22243022