Early brain changes in MS may predict progression

A recent study found it may be possible to help predict the clinical trajectory of individuals with early multiple sclerosis (MS) based on brain radiologic measures during the initial years of interferon beta-1a (Rebif) treatment. The research, conducted by scientists at Amsterdam University Medical Centers in the Netherlands, delved into data from the REFLEX Phase 3 study (NCT00404352) and its extension study, REFLEXION (NCT00813709).

The study, encompassing 262 MS patients with an average age of 31.7 years, focused on MRI scans from the first and second years of treatment. The investigation aimed to discover whether alterations in brain volume, lesions, and atrophy could collectively enhance the prognostic capabilities for clinically definite MS (CDMS) or worsening disability.

Two initial models, one considering MRI changes in the first year and the other in the second year, indicated that a substantial decrease in global brain volume and the presence of new or enlarging lesions were significantly associated with heightened odds of CDMS. Subsequently, a third model incorporating significant predictors from the initial two models revealed that only global brain atrophy in year one and enlarging lesions in year two retained a significant correlation with CDMS.

While the radiological measures did not show significant associations with disability levels or walking function, disappearing lesion volume in the first year and slower central atrophy in the second year were linked to an increased likelihood of experiencing worsening manual dexterity. Moreover, the presence of new or enlarged lesions in the second year emerged as a significant predictor of neurodegeneration, particularly in the ventricular region.

The researchers said this suggests that monitoring changes in brain volume and lesions during the early stages of Rebif treatment may offer valuable insights into predicting the risk of disability and disease progression in individuals with early MS.