Brain volume loss and physical and cognitive impairment in naïve multiple sclerosis patients treated with fingolimod: prospective cohort study in Buenos Aires, Argentina
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Arquivos de neuro-psiquiatria (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2022000800699 |
Resumo: | Abstract Background The percentage of brain volume loss (PBVL) has been classically considered as a biomarker in multiple sclerosis (MS). Objective The objective of the present study was to analyze if the PBVL during the 1st year after the onset of the disease predicts physical and cognitive impairment (CI). Methods Prospective study that included naïve patients without cognitive impairment who initiated MS treatment with fingolimod. Patients were followed for 3 years and relapses, expanded disability status scale (EDSS) progression (defined as worsening of 1 point on the EDSS), the annual PBVL (evaluated by structural image evaluation using normalization of atrophy [SIENA]), and the presence of CI were evaluated. Cognitive impairment was defined in patients who scored at least 2 standard deviations (SDs) below controls on at least 2 domains. The PBVL after 1 year of treatment with fingolimod was used as an independent variable, while CI and EDSS progression at the 3rd year of follow-up as dependent variables. Results A total of 71 patients were included, with a mean age of 35.4 ± 3 years old. At the 3rd year, 14% of the patients were classified as CI and 6.2% had EDSS progression. In the CI group, the PBVL during the 1st year was-0.52 (± 0.07) versus-0.42 (± 0.04) in the no CI group (p < 0.01; odds ratio [OR] = 2.24; 95% confidence interval [CI]: 1.72–2.44). In the group that showed EDSS progression, the PBVL during the 1st year was - 0.59 (± 0.05) versus - 0.42 (± 0.03) (p < 0.01; OR = 2.33; 95%CI: 1.60-2.55). Conclusions A higher PBVL during the 1st year in naïve MS patients was independently associated with a significant risk of CI and EDSS progression. |
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Brain volume loss and physical and cognitive impairment in naïve multiple sclerosis patients treated with fingolimod: prospective cohort study in Buenos Aires, ArgentinaMultiple SclerosisCognitive DysfunctionDisabled PersonsBiomarkersFingolimod HydrochlorideArgentinaAbstract Background The percentage of brain volume loss (PBVL) has been classically considered as a biomarker in multiple sclerosis (MS). Objective The objective of the present study was to analyze if the PBVL during the 1st year after the onset of the disease predicts physical and cognitive impairment (CI). Methods Prospective study that included naïve patients without cognitive impairment who initiated MS treatment with fingolimod. Patients were followed for 3 years and relapses, expanded disability status scale (EDSS) progression (defined as worsening of 1 point on the EDSS), the annual PBVL (evaluated by structural image evaluation using normalization of atrophy [SIENA]), and the presence of CI were evaluated. Cognitive impairment was defined in patients who scored at least 2 standard deviations (SDs) below controls on at least 2 domains. The PBVL after 1 year of treatment with fingolimod was used as an independent variable, while CI and EDSS progression at the 3rd year of follow-up as dependent variables. Results A total of 71 patients were included, with a mean age of 35.4 ± 3 years old. At the 3rd year, 14% of the patients were classified as CI and 6.2% had EDSS progression. In the CI group, the PBVL during the 1st year was-0.52 (± 0.07) versus-0.42 (± 0.04) in the no CI group (p < 0.01; odds ratio [OR] = 2.24; 95% confidence interval [CI]: 1.72–2.44). In the group that showed EDSS progression, the PBVL during the 1st year was - 0.59 (± 0.05) versus - 0.42 (± 0.03) (p < 0.01; OR = 2.33; 95%CI: 1.60-2.55). Conclusions A higher PBVL during the 1st year in naïve MS patients was independently associated with a significant risk of CI and EDSS progression.Academia Brasileira de Neurologia - ABNEURO2022-07-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2022000800699Arquivos de Neuro-Psiquiatria v.80 n.7 2022reponame:Arquivos de neuro-psiquiatria (Online)instname:Academia Brasileira de Neurologiainstacron:ABNEURO10.1055/s-0042-1755277info:eu-repo/semantics/openAccessRojas,Juan IgnacioPatrucco,LilianaPappolla,AgustínSánchez,FranciscoCristiano,Edgardoeng2022-11-18T00:00:00Zoai:scielo:S0004-282X2022000800699Revistahttp://www.scielo.br/anphttps://old.scielo.br/oai/scielo-oai.php||revista.arquivos@abneuro.org1678-42270004-282Xopendoar:2022-11-18T00:00Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologiafalse |
dc.title.none.fl_str_mv |
Brain volume loss and physical and cognitive impairment in naïve multiple sclerosis patients treated with fingolimod: prospective cohort study in Buenos Aires, Argentina |
title |
Brain volume loss and physical and cognitive impairment in naïve multiple sclerosis patients treated with fingolimod: prospective cohort study in Buenos Aires, Argentina |
spellingShingle |
Brain volume loss and physical and cognitive impairment in naïve multiple sclerosis patients treated with fingolimod: prospective cohort study in Buenos Aires, Argentina Rojas,Juan Ignacio Multiple Sclerosis Cognitive Dysfunction Disabled Persons Biomarkers Fingolimod Hydrochloride Argentina |
title_short |
Brain volume loss and physical and cognitive impairment in naïve multiple sclerosis patients treated with fingolimod: prospective cohort study in Buenos Aires, Argentina |
title_full |
Brain volume loss and physical and cognitive impairment in naïve multiple sclerosis patients treated with fingolimod: prospective cohort study in Buenos Aires, Argentina |
title_fullStr |
Brain volume loss and physical and cognitive impairment in naïve multiple sclerosis patients treated with fingolimod: prospective cohort study in Buenos Aires, Argentina |
title_full_unstemmed |
Brain volume loss and physical and cognitive impairment in naïve multiple sclerosis patients treated with fingolimod: prospective cohort study in Buenos Aires, Argentina |
title_sort |
Brain volume loss and physical and cognitive impairment in naïve multiple sclerosis patients treated with fingolimod: prospective cohort study in Buenos Aires, Argentina |
author |
Rojas,Juan Ignacio |
author_facet |
Rojas,Juan Ignacio Patrucco,Liliana Pappolla,Agustín Sánchez,Francisco Cristiano,Edgardo |
author_role |
author |
author2 |
Patrucco,Liliana Pappolla,Agustín Sánchez,Francisco Cristiano,Edgardo |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Rojas,Juan Ignacio Patrucco,Liliana Pappolla,Agustín Sánchez,Francisco Cristiano,Edgardo |
dc.subject.por.fl_str_mv |
Multiple Sclerosis Cognitive Dysfunction Disabled Persons Biomarkers Fingolimod Hydrochloride Argentina |
topic |
Multiple Sclerosis Cognitive Dysfunction Disabled Persons Biomarkers Fingolimod Hydrochloride Argentina |
description |
Abstract Background The percentage of brain volume loss (PBVL) has been classically considered as a biomarker in multiple sclerosis (MS). Objective The objective of the present study was to analyze if the PBVL during the 1st year after the onset of the disease predicts physical and cognitive impairment (CI). Methods Prospective study that included naïve patients without cognitive impairment who initiated MS treatment with fingolimod. Patients were followed for 3 years and relapses, expanded disability status scale (EDSS) progression (defined as worsening of 1 point on the EDSS), the annual PBVL (evaluated by structural image evaluation using normalization of atrophy [SIENA]), and the presence of CI were evaluated. Cognitive impairment was defined in patients who scored at least 2 standard deviations (SDs) below controls on at least 2 domains. The PBVL after 1 year of treatment with fingolimod was used as an independent variable, while CI and EDSS progression at the 3rd year of follow-up as dependent variables. Results A total of 71 patients were included, with a mean age of 35.4 ± 3 years old. At the 3rd year, 14% of the patients were classified as CI and 6.2% had EDSS progression. In the CI group, the PBVL during the 1st year was-0.52 (± 0.07) versus-0.42 (± 0.04) in the no CI group (p < 0.01; odds ratio [OR] = 2.24; 95% confidence interval [CI]: 1.72–2.44). In the group that showed EDSS progression, the PBVL during the 1st year was - 0.59 (± 0.05) versus - 0.42 (± 0.03) (p < 0.01; OR = 2.33; 95%CI: 1.60-2.55). Conclusions A higher PBVL during the 1st year in naïve MS patients was independently associated with a significant risk of CI and EDSS progression. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-07-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2022000800699 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2022000800699 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1055/s-0042-1755277 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Academia Brasileira de Neurologia - ABNEURO |
publisher.none.fl_str_mv |
Academia Brasileira de Neurologia - ABNEURO |
dc.source.none.fl_str_mv |
Arquivos de Neuro-Psiquiatria v.80 n.7 2022 reponame:Arquivos de neuro-psiquiatria (Online) instname:Academia Brasileira de Neurologia instacron:ABNEURO |
instname_str |
Academia Brasileira de Neurologia |
instacron_str |
ABNEURO |
institution |
ABNEURO |
reponame_str |
Arquivos de neuro-psiquiatria (Online) |
collection |
Arquivos de neuro-psiquiatria (Online) |
repository.name.fl_str_mv |
Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologia |
repository.mail.fl_str_mv |
||revista.arquivos@abneuro.org |
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