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Monday

 

The natural history of brain volume loss among patients with multiple sclerosis: A systematic literature review and meta-analysis: STUDY



















































Abstract

Background:
Multiple sclerosis has been associated with progressive brain volume loss.

Objective:
We aimed to systematically summarize reported rates of brain volume loss in multiple sclerosis and explore associations between brain volume loss and markers of disease severity.

Methods:
A systematic literature search (2003–2013) was conducted to identify studies with ≥ 12 months of follow-up, reported brain volume measurement algorithms, and changes in brain volume. Meta-analysis random-effects models were applied. Associations between brain volume change, changes in lesion volume and disease duration were examined in pre-specified meta-regression models.

Results:
We identified 38 studies. For the meta-analysis, 12 studies that reported annualized percentage brain volume change (PBVC), specified first-generation disease-modifying treatments (e.g., interferon-beta or glatiramer acetate) and used Structural Image Evaluation of Normalized Atrophy algorithm were analyzed. The annualized PBVC ranged from − 1.34% to − 0.46% per year. The pooled PBVC was − 0.69% (95%CI = − 0.87% to − 0.50%) in study arms receiving first-generation disease-modifying treatments (N = 6 studies) and − 0.71% (95%CI = − 0.81% to − 0.61%) in untreated study arms (N = 6 studies).

Conclusions:
In this study, the average multiple sclerosis patient receiving first-generation disease-modifying treatment or no disease-modifying treatment lost approximately 0.7% of brain volume/year, well above rates associated with normal aging (0.1%-0.3% of brain volume/year).

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