Changes in Retinal Thickness and Brain Volume during 6.8-Year Escalating Therapy for Multiple Sclerosis

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Borgström, MaxLinköpings universitet,Avdelningen för neurobiologi,Medicinska fakulteten,Region Östergötland, Neurologiska kliniken i Linköping (author)

Changes in Retinal Thickness and Brain Volume during 6.8-Year Escalating Therapy for Multiple Sclerosis

Article/chapterEnglish2023

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WILEY,2023
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LIBRIS-ID:oai:DiVA.org:liu-201200
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-201200URI
https://doi.org/10.1155/2023/7587221DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:154932528URI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Funding Agencies|Faculty of Medicine and Health Sciences at Linkoping University; Linkoping University Hospital; Henry and Ella Margareta Stahl Foundation; County Council of Ostergotland and Linkoping University Hospital [LIO-799111, LIO-940688, LIO 941169]
Background. Different disease-modifying therapies (DMT) for multiple sclerosis (MS) have disparate effects on disability outcomes. Sweden has a leading position globally in initiating high-efficacy DMT instead of escalating DMT from 1(st)-line to high-efficacy DMT. With optical coherence tomography (OCT), retinal changes can be measured at a few micrometer level. OCT has been increasingly applied in diagnosing MS and monitoring disease course and therapeutic effect. Objective. We investigate the effects of 1(st)-line versus high-efficacy DMT for MS on retinal and brain atrophy and on functional outcomes during 6.8 years of escalating DMT. Materials and Methods. In this prospective longitudinal observational study, 18 MS patients were followed up for 6.8 years. Twelve of the patients were untreated at baseline. All patients underwent 1(st)-line DMT for median duration of 2.4 years and then switched to high-efficacy DMT for a median duration of 2.9 years. Findings from neurological examinations, MRI, and OCT measures were registered 2-4 times per year. Results. Ganglion cell-inner plexiform layer (GCIPL) thickness was significantly reduced during 1(st)-line DMT (73.75 mu m, p < 0.01) compared to baseline (76.38 mu m). During high-efficacy DMT, thickness reduction was slower (73.27 mu m, p < 0.05), and MRI contrast-loading lesions vanished (p < 0.01). However, brain parenchymal fraction (BPF) decreased during high-efficacy DMT compared to 1(st)-line DMT. Estimated models showed similar results. Conclusion. GCIPL decline was most profound during 1(st)-line DMT and diminished during high-efficacy DMT. MRI contrast lesions vanished during high-efficacy DMT. However, brain atrophy continued regardless of high-efficacy DMT.

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Fredrikson, MatsLinköpings universitet,Avdelningen för inflammation och infektion,Forum Östergötland(Swepub:liu)matfr43 (author)
Vrethem, MagnusLinköpings universitet,Avdelningen för neurobiologi,Medicinska fakulteten,Region Östergötland, Neurologiska kliniken i Linköping(Swepub:liu)magvr07 (author)
Mirabelli, PierfrancescoLinköpings universitet,Institutionen för biomedicinska och kliniska vetenskaper,Medicinska fakulteten,Region Östergötland, Ögonkliniken(Swepub:liu)piemi17x (author)
Link, HansKarolinska Inst, Sweden (author)
Link, YuminLinköpings universitet,Avdelningen för neurobiologi,Medicinska fakulteten,Region Östergötland, Neurologiska kliniken i Linköping(Swepub:liu)yumli79 (author)
Linköpings universitetAvdelningen för neurobiologi (creator_code:org_t)

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In:Acta Neurologica Scandinavica: WILEY20230001-63141600-0404

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By the author/editor: Borgström, Max; Fredrikson, Mats; Vrethem, Magnus; Mirabelli, Pierf ...; Link, Hans; Link, Yumin

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Ophthalmology

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By the university: Linköping University; Karolinska Institutet

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