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Neurology and Therapy
Published in: Neurology and Therapy 2/2016

Open Access 01-12-2016 | Original Research

The Effect of Dimethyl Fumarate on Cerebral Gray Matter Atrophy in Multiple Sclerosis

Authors: Sheena L. Dupuy, Shahamat Tauhid, Shelley Hurwitz, Renxin Chu, Fawad Yousuf, Rohit Bakshi

Published in: Neurology and Therapy | Issue 2/2016

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Abstract

Introduction

The objective of this pilot study was to compare cerebral gray matter (GM) atrophy over 1 year in patients starting dimethyl fumarate (DMF) for multiple sclerosis (MS) to that of patients on no disease-modifying treatment (noDMT). DMF is an established therapy for relapsing–remitting (RR) MS.

Methods

We retrospectively analyzed 20 patients with RRMS at the start of DMF [age (mean ± SD) 46.1 ± 10.2 years, Expanded Disability Status Scale (EDSS) score 1.1 ± 1.2, timed 25-foot walk (T25FW) 4.6 ± 0.8 s] and eight patients on noDMT (age 42.5 ± 6.6 years, EDSS 1.7 ± 1.1, T25FW 4.4 ± 0.6 s). Baseline and 1-year 3D T1-weighted 3T MRI was processed with automated pipelines (SIENA, FSL-FIRST) to assess percentage whole brain volume change (PBVC) and deep GM (DGM) atrophy. Group differences were assessed by analysis of covariance, with time between MRI scans as a covariate.

Results

Over 1 year, the DMF group showed a lower rate of whole brain atrophy than the noDMT group (PBVC: −0.37 ± 0.49% vs. −1.04 ± 0.67%, p = 0.005). The DMF group also had less change in putamen volume (−0.06 ± 0.22 vs. −0.32 ± 0.28 ml, p = 0.02). There were no significant on-study differences between groups in caudate, globus pallidus, thalamus, total DGM volume, T2 lesion volume, EDSS, or T25FW (all p > 0.20).

Conclusions

These results suggest a treatment effect of DMF on GM atrophy appearing at 1 year after starting therapy. However, due to the retrospective study design and sample size, these findings should be considered preliminary, and require confirmation in future investigations.

Funding

Biogen.
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Metadata
Title
The Effect of Dimethyl Fumarate on Cerebral Gray Matter Atrophy in Multiple Sclerosis
Authors
Sheena L. Dupuy
Shahamat Tauhid
Shelley Hurwitz
Renxin Chu
Fawad Yousuf
Rohit Bakshi
Publication date
01-12-2016
Publisher
Springer Healthcare
Published in
Neurology and Therapy / Issue 2/2016
Print ISSN: 2193-8253
Electronic ISSN: 2193-6536
DOI
https://doi.org/10.1007/s40120-016-0054-4

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