جستجو در تالارهای گفتگو

The disease-modifying drugs currently available for MS have well-established effects on relapse rate and white matter lesion development. Whether they also help to protect gray matter has been an open question, primarily due to the difficulties in imaging gray matter lesions. However, since gray matter pathology has been linked with disability and cognitive dysfunction, it is important to learn what effect standard therapies might have in these regions A team of scientists in Italy has performed a study on this topic using an MRI technique called double-inversion recovery (DIR), which is capable of imaging lesions in the cortex (the gray matter layer that constitutes the outer edge of the brain). Their study included 165 people with MS randomized to one of three treatments (two forms of interferon-beta and glatiramer acetate). Also included were 50 people with MS who chose not to be treated (due to benign course, needle phobia, pregnancy plans, etc.). Subjects were imaged at baseline and at 12 and 24 months At both timepoints, the treated subjects were less likely to have developed new cortical lesions than the untreated subjects . The number of new cortical lesions was also lower in the treated vs. untreated subjects. Comparing across the different drugs, the largest effects were seen in those subjects taking IFN-b 1a 44 mcg subcutaneous 3x/week, followed by glatiramer acetate, followed by IFN-b 1a 30 mcg intramuscular 1x/week. These differences across drugs were greater at 12 months, and still present but less pronounced at 24 months. The treated subjects also had lower rates of gray matter atrophy compared with untreated subjects (no differences across drugs). As expected, white matter lesion development and relapse rates were also lower in the treated vs. untreated subjects This study suggests that the first-line disease-modifying drugs for MS may curb lesion-promoting inflammation in the cortex as well as in the white matter. It is encouraging to think that this critical area of the brain could receive some protection by available MS drugs. Hopefully this line of investigation will be continued, and expanded to include the emerging MS drugs as well