Finn,
That's interesting stuff on gray matter from Lucchinetti et al.
I just noticed this related abstract (which was posted by Raven over 2 years ago, yet was just published 2 months ago).
Interferons aren't great MS treatments, but maybe their impacts on gray matter degeneration are significant.
I'll try to space this out to move us to a new page...
Interferon beta-1a slows progression of brain atrophy in
relapsing-remitting multiple sclerosis predominantly by reducing gray matter atrophy
R. Zivadinov - Department of Neurology, Buffalo Neuroimaging Analysis
Center, The Jacobs Neurological Institute, University at Buffalo, State
University of New York, Buffalo, NY, USA,
rzivadinov@thejni.org
L. Locatelli - Department of Clinical Medicine and Neurology, University of
Trieste, Trieste, Italy
D. Cookfair - Department of Neurology, Buffalo Neuroimaging Analysis
Center, The Jacobs Neurological Institute, University at Buffalo, State
University of New York, Buffalo, NY, USA
B. Srinivasaraghavan - Department of Neurology, Buffalo Neuroimaging
Analysis Center, The Jacobs Neurological Institute, University at Buffalo,
State University of New York, Buffalo, NY, USA
A. Bertolotto - Centro Riferimento Regionale Sclerosi Multipla (CReSM)
and Laboratori di Neurobiologia Clinica, Ospedale Universitario San Luigi,
Orbassano, Italy
M. Ukmar - Department of Clinical, Morphological and Technological
Sciences, University of Trieste, Trieste, Italy
A. Bratina - Department of Clinical Medicine and Neurology, University of
Trieste, Trieste, Italy
C. Maggiore - Department of Clinical Medicine and Neurology, University
of Trieste, Trieste, Italy
A. Bosco - Department of Clinical Medicine and Neurology, University of
Trieste, Trieste, Italy
A. Grop - Department of Neurology, Buffalo Neuroimaging Analysis
Center, The Jacobs Neurological Institute, University at Buffalo, State
University of New York, Buffalo, NY, USA
M. Catalan - Department of Clinical Medicine and Neurology, University of
Trieste, Trieste, Italy
M. Zorzon - Department of Clinical Medicine and Neurology, University of
Trieste, Trieste, Italy
Background
Brain atrophy, as assessed by magnetic resonance imaging (MRI), has
been correlated with disability in patients with multiple sclerosis (MS).
Recent evidence indicates that both white matter (WM) and gray matter
(GM) are subject to atrophy in patients with MS. Although neurological
deficiencies in MS are primarily due to loss of WM, the clinical significance
of GM atrophy has not been fully explored in MS.
Methods
We have undertaken a three-year, open-label study, comparing 26
patients who elected to receive intramuscular interferon beta-1a (IFN
ß-1a) therapy, with 28 patients who elected not to receive therapy. Both
groups had quantitative cranial MRI scans at study entry and after three
years, and standardized clinical assessments every six months. Brain
parenchymal fraction (BPF), GM fraction (GMF), and WM fraction (WMF)
percent changes were calculated, and T2- and T1-lesion volumes (LVs)
assessed.
Results
After three years, mean percent
change in BPF favored the IFN ß-1a
treatment group (IFN ß-1a —1.3% versus the control group —2.5%,
P=0.009), as did the mean percent change in GMF (+0.2 versus —1.4%,
P=0.014), and the mean percent change in T1-LV (—9.3 versus +91.6%,
P=0.011). At the end of the study, there was a significant within-patient
decrease in BPF for both groups (P=0.02 for the IFN ß-1a treatment group,
and P<0.001 for the control group), a significant within-patient decrease
in WMF for the IFN ß-1a treatment group (P=0.01), and a significant
decrease in GMF for the control group (P=0.013) when compared with
baseline.
Conclusion
Over a three-year period, treatment with IFN ß-1a significantly slowed the
progression of whole-brain and GM atrophy, and of T1-hypointense LV
accumulation, when compared with the control group.
http://msj.sagepub.com/cgi/content/abstract/13/4/490
