Display options
Cite
Tsivgoulis G, Katsanos AH, Grigoriadis N, et al. The effect of disease-modifying therapies on brain atrophy in patients with clinically isolated syndrome: a systematic review and meta-analysis. Ther Adv Neurol Disord. 2015;8(5):193-202doi: 10.1177/1756285615600381.
Tsivgoulis, G., Katsanos, A. H., Grigoriadis, N., Hadjigeorgiou, G. M., Heliopoulos, I., Papathanasopoulos, P., Dardiotis, E., Kilidireas, C., Voumvourakis, K. (2015). The effect of disease-modifying therapies on brain atrophy in patients with clinically isolated syndrome: a systematic review and meta-analysis. Therapeutic advances in neurological disorders, 8(5), 193-202. https://doi.org/10.1177/1756285615600381
Tsivgoulis, Georgios, et al. "The effect of disease-modifying therapies on brain atrophy in patients with clinically isolated syndrome: a systematic review and meta-analysis." Therapeutic advances in neurological disorders vol. 8,5 (2015): 193-202. doi: https://doi.org/10.1177/1756285615600381
Tsivgoulis G, Katsanos AH, Grigoriadis N, Hadjigeorgiou GM, Heliopoulos I, Papathanasopoulos P, Dardiotis E, Kilidireas C, Voumvourakis K. The effect of disease-modifying therapies on brain atrophy in patients with clinically isolated syndrome: a systematic review and meta-analysis. Ther Adv Neurol Disord. 2015 Sep;8(5):193-202. doi: 10.1177/1756285615600381. PMID: 26557896; PMCID: PMC4622115.
Copy Download .nbib Format: NLM
Share it on

Ther Adv Neurol Disord. 2015 Sep;8(5):193-202. doi: 10.1177/1756285615600381.

The effect of disease-modifying therapies on brain atrophy in patients with clinically isolated syndrome: a systematic review and meta-analysis.

Therapeutic advances in neurological disorders

Georgios Tsivgoulis, Aristeidis H Katsanos, Nikolaos Grigoriadis, Georgios M Hadjigeorgiou, Ioannis Heliopoulos, Panagiotis Papathanasopoulos, Efthimios Dardiotis, Constantinos Kilidireas, Konstantinos Voumvourakis,

Affiliations

  1. Second Department of Neurology, School of Medicine, University of Athens, Iras 39, Gerakas Attikis, Athens, 15344, Greece.
  2. Second Department of Neurology, 'Attikon' Hospital, School of Medicine, University of Athens, Athens, Greece.
  3. Second Department of Neurology, 'AHEPA' University Hospital, Aristotelion University of Thessaloniki, Thessaloniki, Greece.
  4. Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece.
  5. Department of Neurology, Alexandroupolis University Hospital, Democritus University of Thrace, Alexandroupolis, Greece.
  6. Department of Neurology, University of Patras Medical School, Patras, Greece.
  7. First Department of Neurology, 'Eginition' Hospital, School of Medicine, University of Athens, Athens, Greece.

PMID: 26557896 PMCID: PMC4622115 DOI: 10.1177/1756285615600381

Abstract

OBJECTIVES: Brain atrophy is associated with cognitive deficits in patients with clinically isolated syndrome (CIS) and can predict conversion to clinical definite multiple sclerosis. The aim of the present meta-analysis was to evaluate the effect of disease-modifying drugs (DMDs) on brain atrophy in patients with CIS.

METHODS: Eligible placebo-control randomized clinical trials of patients with CIS that had reported changes in brain volume during the study period were identified by searching the MEDLINE, SCOPUS, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. This meta-analysis adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews and meta-analyses.

RESULTS: Three eligible studies were identified, comprising 1362 patients. The mean percentage change in brain volume was found to be significantly lower in DMD-treated patients versus placebo-treated subgroups (standardized mean difference [SMD]: = -0.13, 95% confidence interval [CI]: -0.25, 0.01; p = 0.04). In the subgroup analysis of the two studies that provided data on brain-volume changes for the first (0-12 months) and second (13-24 months) year of treatment, DMD attenuated brain-volume loss in comparison with placebo during the second year (SMD = -0.25; 95% CI: -0.43, -0.07; p < 0.001), but not during the first year of treatment (SMD = -0.01; 95% CI: -0.27, 0.24; p = 0.93). No evidence of heterogeneity was found between estimates, while funnel-plot inspection revealed no evidence of publication bias.

CONCLUSIONS: DMDs appear to attenuate brain atrophy over time in patients with CIS. The effect of DMDs on brain-volume loss is evident after the first year of treatment.

Keywords: brain atrophy; brain volume; clinically isolated syndrome; disease modifying therapy

References

  1. J Neurol. 2000 Dec;247(12):960-5 - PubMed
  2. Neurology. 2014 Oct 21;83(17):1523-9 - PubMed
  3. J Neurol. 2013 Jul;260(7):1901-6 - PubMed
  4. AJNR Am J Neuroradiol. 2010 Aug;31(7):1171-7 - PubMed
  5. BMJ. 2011 Jul 22;343:d4002 - PubMed
  6. Brain. 2002 Feb;125(Pt 2):327-37 - PubMed
  7. N Engl J Med. 2000 Sep 28;343(13):898-904 - PubMed
  8. Neurology. 2013 Jun 4;80(23):2090-4 - PubMed
  9. J Neurol Sci. 2012 Jan 15;312(1-2):7-12 - PubMed
  10. J Neurol Neurosurg Psychiatry. 2015 Apr;86(4):410-8 - PubMed
  11. Neurology. 2006 Oct 10;67(7):1242-9 - PubMed
  12. Mult Scler. 2013 Dec;19(14):1878-86 - PubMed
  13. Lancet Neurol. 2012 Dec;11(12):1082-92 - PubMed
  14. Brain. 2001 Sep;124(Pt 9):1803-12 - PubMed
  15. Neurol Sci. 2010 Nov;31(Suppl 2):S245-8 - PubMed
  16. Lancet Neurol. 2006 Feb;5(2):158-70 - PubMed
  17. Lancet Neurol. 2012 Jan;11(1):33-41 - PubMed
  18. Cochrane Database Syst Rev. 2013 Dec 20;(12):ED000075 - PubMed
  19. J Neurol Sci. 2014 Jul 15;342(1-2):62-8 - PubMed
  20. Neurology. 2008 Jul 8;71(2):136-44 - PubMed
  21. Lancet Neurol. 2014 Oct;13(10):977-86 - PubMed
  22. J Neuroimaging. 2004 Jul;14(3 Suppl):36S-45S - PubMed
  23. Mult Scler. 2013 Jul;19(8):1074-83 - PubMed
  24. Neurology. 2010 Jun 8;74(23):1868-76 - PubMed
  25. J Neuroimaging. 2005;15(4 Suppl):30S-45S - PubMed
  26. J Clin Epidemiol. 2009 Oct;62(10):e1-34 - PubMed
  27. Mult Scler. 2014 Nov;20(13):1704-13 - PubMed
  28. Neuroimage. 2002 Sep;17(1):479-89 - PubMed
  29. CNS Drugs. 2014 Feb;28(2):147-56 - PubMed
  30. J Neurol. 2004 Apr;251(4):432-9 - PubMed
  31. AJNR Am J Neuroradiol. 2012 Sep;33(8):1573-8 - PubMed
  32. J Neurol Neurosurg Psychiatry. 2010 Jun;81(6):690-5 - PubMed
  33. Neuroimage Clin. 2014 Sep 28;6:312-9 - PubMed
  34. Lancet. 2004 Oct 23-29;364(9444):1489-96 - PubMed
  35. BMJ. 2011 Oct 18;343:d5928 - PubMed
  36. J Neurol. 2009 Sep;256(9):1397-412 - PubMed
  37. Nat Rev Neurol. 2009 May;5(5):256-66 - PubMed

Publication Types