How do we measure nerve loss?
The imagers tell us it is grey matter loss that holds the key.
So what’s new here?
The imagers tell us it is grey matter loss that holds the key.
So what’s new here?
About ten years ago I was at a meeting where a very distinguished MRI expert was saying that ‘whole brain volume’ was not a good outcome measure to monitor progression and that grey matter volume was a much more responsive outcome measure.
However, we (the neuros should I say) have continued to use whole brain atrophy as an outcome measure, and trials have failed, over and over again.
The white matter may swell due to the inflammatory activity and shrink when the immune response goes.
This study suggests that grey matter loss best correlates with disability. So when will people start to listen?
High-dose biotin made the brain shrink and the EMA want more data.
Statins slowed the shrinkage, does it mean it is good?
People are using cord shrinkage as an outcome, but again it has problems as we have shown that it may miss a lot of the nerve loss.
However, we (the neuros should I say) have continued to use whole brain atrophy as an outcome measure, and trials have failed, over and over again.
The white matter may swell due to the inflammatory activity and shrink when the immune response goes.
This study suggests that grey matter loss best correlates with disability. So when will people start to listen?
High-dose biotin made the brain shrink and the EMA want more data.
Statins slowed the shrinkage, does it mean it is good?
People are using cord shrinkage as an outcome, but again it has problems as we have shown that it may miss a lot of the nerve loss.
Eshaghi A, Prados F, Brownlee W, Altmann DR, Tur C, Cardoso MJ, De Angelis F, van de Pavert SH, Cawley N, De Stefano N, Stromillo ML, Battaglini M, Ruggieri S, Gasperini C, Filippi M, Rocca MA, Rovira A, Sastre-Garriga J, Vrenken H, Leurs CE, Killestein J, Pirpamer L, Enzinger C, Ourselin S, Wheeler-Kingshott CAMG, Chard D, Thompson AJ, Alexander DC, Barkhof F, Ciccarelli O; MAGNIMS study group. Ann Neurol. 2018. doi: 10.1002/ana.25145. [Epub ahead of print]
I copy here my unrelated comment for the sake of the discussion (spam it if its unnecessary)
1. A recent study found that Gilenya halts grey matter atrophy
http://www.sciencedirect.com/science/article/pii/S0022510X17343848
2. Gilenya is less effective than Tysabri in delaying progression
https://onlinelibrary.ectrims-congress.eu/ectrims/2017/ACTRIMS-ECTRIMS2017/202481/j.william.l.brown.the.effect.of.disease-modifying.treatments.on.conversion.to.html?f=media=3*speaker=546949
The risk (assessed as hazard ratios) to convert to SPMS among patients treated with injectables was 0.31 (follow-up of 7.9 years), 0.23 with Gilenya (follow-up 4.6 years), 0.50 with Tysabri (follow-up 4.9 years), and 0.60 with Lemtrada (follow-up 7.2 years), compared to matched untreated patients. The higher the hazard ratio, the lesser the risk.
What are your thoughts?
Does Ibudilast prevent grey matter atrophy or just whole brain atrophy?
i think I remember brain atrophy I don't remember grey matter atrophy being mentioned
Guessing that data isn't know yet, Iz.
I've heard the comment on here before that BVL is an unreliable outcome measure as brain volume measures are effected by both atrophy and swelling. Does this method circumnavigate that problem or is it also vulnerable to being confounded by swelling?