Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1999 Nov;67(5):579–584. doi: 10.1136/jnnp.67.5.579

Interferon-β-1a in relapsing-remitting multiple sclerosis: effect on hypointense lesion volume on T1 weighted images

C Gasperini 1, C Pozzilli 1, S Bastianello 1, E Giugni 1, M Horsfield 1, T Koudriavtseva 1, S Galgani 1, A Paolillo 1, S Haggiag 1, E Millefiorini 1, C Fieschi 1
PMCID: PMC1736645  PMID: 10519861

Abstract

OBJECTIVE—Recently, a strong correlation between the increase in hypointense lesion load on T1 weighted spin echo images, and the increase in disability was reported. Although the effect of interferon-β has been demonstrated both in reducing exacerbation rate, frequency of enhancing lesions, and accumulation of disease burden on T2 weighted images, the impact on the accumulation of hypointense lesions has not yet been evaluated. The aims of the present study were: (a) to assess for the first time the effect of interferon-β-1a on T1 weighted MRI hypointense lesion volume; and (b) to evaluate the relation between changes on hypointense, hyperintense, and enhancing lesion volume before and during interferon-β-1a treatment in relapsing-remitting multiple sclerosis.
METHODS—After a baseline scan and 6 month pretreatment period, 67 patients with relapsing-remitting multiple sclerosis were treated with interferon-β-1a by subcutaneous injection three times a week during a 12 month treatment period. All patients had MRI every month during the 6 month pretreatment period and for the first 9 months of the treatment period. A final MRI was also performed at the end of the 12 month treatment period.
RESULTS—There was a significant increase in the mean hyperintense lesion volume during the pretreatment phase (6 months) and a slight decrease during the treatment period (12 months), whereas the hypointense lesion volume increased significantly before treatment and remained substantially stable during treatment. There was a significant correlation between changes in hypointense and hyperintense lesion volume during the observation period, but not during treatment. The monthly mean volume of Gadolinium-DTPA enhancing lesions was significantly higher during the pretreatment than the treatment period, and the enhancing lesion volume correlated with changes of hyperintense and hypointense lesion volumes only during the observation period.
CONCLUSION—These data suggest that interferon-β-1a has a stabilising effect on T1 weighted hypointense lesion volume.



Full Text

The Full Text of this article is available as a PDF (104.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Filippi M., Horsfield M. A., Morrissey S. P., MacManus D. G., Rudge P., McDonald W. I., Miller D. H. Quantitative brain MRI lesion load predicts the course of clinically isolated syndromes suggestive of multiple sclerosis. Neurology. 1994 Apr;44(4):635–641. doi: 10.1212/wnl.44.4.635. [DOI] [PubMed] [Google Scholar]
  2. Gasperini C., Horsfield M. A., Thorpe J. W., Kidd D., Barker G. J., Tofts P. S., MacManus D. G., Thompson A. J., Miller D. H., McDonald W. I. Macroscopic and microscopic assessments of disease burden by MRI in multiple sclerosis: relationship to clinical parameters. J Magn Reson Imaging. 1996 Jul-Aug;6(4):580–584. doi: 10.1002/jmri.1880060404. [DOI] [PubMed] [Google Scholar]
  3. Grimaud J., Lai M., Thorpe J., Adeleine P., Wang L., Barker G. J., Plummer D. L., Tofts P. S., McDonald W. I., Miller D. H. Quantification of MRI lesion load in multiple sclerosis: a comparison of three computer-assisted techniques. Magn Reson Imaging. 1996;14(5):495–505. doi: 10.1016/0730-725x(96)00018-5. [DOI] [PubMed] [Google Scholar]
  4. Hiehle J. F., Jr, Lenkinski R. E., Grossman R. I., Dousset V., Ramer K. N., Schnall M. D., Cohen J. A., Gonzalez-Scarano F. Correlation of spectroscopy and magnetization transfer imaging in the evaluation of demyelinating lesions and normal appearing white matter in multiple sclerosis. Magn Reson Med. 1994 Sep;32(3):285–293. doi: 10.1002/mrm.1910320303. [DOI] [PubMed] [Google Scholar]
  5. Horsfield M. A., Lai M., Webb S. L., Barker G. J., Tofts P. S., Turner R., Rudge P., Miller D. H. Apparent diffusion coefficients in benign and secondary progressive multiple sclerosis by nuclear magnetic resonance. Magn Reson Med. 1996 Sep;36(3):393–400. doi: 10.1002/mrm.1910360310. [DOI] [PubMed] [Google Scholar]
  6. Jacobs L. D., Cookfair D. L., Rudick R. A., Herndon R. M., Richert J. R., Salazar A. M., Fischer J. S., Goodkin D. E., Granger C. V., Simon J. H. Intramuscular interferon beta-1a for disease progression in relapsing multiple sclerosis. The Multiple Sclerosis Collaborative Research Group (MSCRG) Ann Neurol. 1996 Mar;39(3):285–294. doi: 10.1002/ana.410390304. [DOI] [PubMed] [Google Scholar]
  7. Leppert D., Waubant E., Bürk M. R., Oksenberg J. R., Hauser S. L. Interferon beta-1b inhibits gelatinase secretion and in vitro migration of human T cells: a possible mechanism for treatment efficacy in multiple sclerosis. Ann Neurol. 1996 Dec;40(6):846–852. doi: 10.1002/ana.410400606. [DOI] [PubMed] [Google Scholar]
  8. Loevner L. A., Grossman R. I., McGowan J. C., Ramer K. N., Cohen J. A. Characterization of multiple sclerosis plaques with T1-weighted MR and quantitative magnetization transfer. AJNR Am J Neuroradiol. 1995 Aug;16(7):1473–1479. [PMC free article] [PubMed] [Google Scholar]
  9. McFarland H. F., Frank J. A., Albert P. S., Smith M. E., Martin R., Harris J. O., Patronas N., Maloni H., McFarlin D. E. Using gadolinium-enhanced magnetic resonance imaging lesions to monitor disease activity in multiple sclerosis. Ann Neurol. 1992 Dec;32(6):758–766. doi: 10.1002/ana.410320609. [DOI] [PubMed] [Google Scholar]
  10. Miller D. H., Albert P. S., Barkhof F., Francis G., Frank J. A., Hodgkinson S., Lublin F. D., Paty D. W., Reingold S. C., Simon J. Guidelines for the use of magnetic resonance techniques in monitoring the treatment of multiple sclerosis. US National MS Society Task Force. Ann Neurol. 1996 Jan;39(1):6–16. doi: 10.1002/ana.410390104. [DOI] [PubMed] [Google Scholar]
  11. Miller D. H., Grossman R. I., Reingold S. C., McFarland H. F. The role of magnetic resonance techniques in understanding and managing multiple sclerosis. Brain. 1998 Jan;121(Pt 1):3–24. doi: 10.1093/brain/121.1.3. [DOI] [PubMed] [Google Scholar]
  12. Molyneux P. D., Filippi M., Barkhof F., Gasperini C., Yousry T. A., Truyen L., Lai H. M., Rocca M. A., Moseley I. F., Miller D. H. Correlations between monthly enhanced MRI lesion rate and changes in T2 lesion volume in multiple sclerosis. Ann Neurol. 1998 Mar;43(3):332–339. doi: 10.1002/ana.410430311. [DOI] [PubMed] [Google Scholar]
  13. Newcombe J., Hawkins C. P., Henderson C. L., Patel H. A., Woodroofe M. N., Hayes G. M., Cuzner M. L., MacManus D., du Boulay E. P., McDonald W. I. Histopathology of multiple sclerosis lesions detected by magnetic resonance imaging in unfixed postmortem central nervous system tissue. Brain. 1991 Apr;114(Pt 2):1013–1023. doi: 10.1093/brain/114.2.1013. [DOI] [PubMed] [Google Scholar]
  14. Paolillo A., Bastianello S., Frontoni M., Gasperini C., Giugni E., Ciccarelli O., Luccichenti G., Cannoni S., Pozzilli C. Magnetic resonance imaging outcome of new enhancing lesions in relapsing-remitting multiple sclerosis patients treated with interferon beta1a. J Neurol. 1999 Jun;246(6):443–448. doi: 10.1007/s004150050380. [DOI] [PubMed] [Google Scholar]
  15. Paty D. W., Li D. K. Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. II. MRI analysis results of a multicenter, randomized, double-blind, placebo-controlled trial. UBC MS/MRI Study Group and the IFNB Multiple Sclerosis Study Group. Neurology. 1993 Apr;43(4):662–667. doi: 10.1212/wnl.43.4.662. [DOI] [PubMed] [Google Scholar]
  16. Pozzilli C., Bastianello S., Koudriavtseva T., Gasperini C., Bozzao A., Millefiorini E., Galgani S., Buttinelli C., Perciaccante G., Piazza G. Magnetic resonance imaging changes with recombinant human interferon-beta-1a: a short term study in relapsing-remitting multiple sclerosis. J Neurol Neurosurg Psychiatry. 1996 Sep;61(3):251–258. doi: 10.1136/jnnp.61.3.251. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Prineas J. W., Barnard R. O., Revesz T., Kwon E. E., Sharer L., Cho E. S. Multiple sclerosis. Pathology of recurrent lesions. Brain. 1993 Jun;116(Pt 3):681–693. doi: 10.1093/brain/116.3.681. [DOI] [PubMed] [Google Scholar]
  18. Rosenberg G. A., Dencoff J. E., Correa N., Jr, Reiners M., Ford C. C. Effect of steroids on CSF matrix metalloproteinases in multiple sclerosis: relation to blood-brain barrier injury. Neurology. 1996 Jun;46(6):1626–1632. doi: 10.1212/wnl.46.6.1626. [DOI] [PubMed] [Google Scholar]
  19. Rovaris M., Filippi M., Calori G., Rodegher M., Campi A., Colombo B., Comi G. Intra-observer reproducibility in measuring new putative MR markers of demyelination and axonal loss in multiple sclerosis: a comparison with conventional T2-weighted images. J Neurol. 1997 Apr;244(4):266–270. doi: 10.1007/s004150050083. [DOI] [PubMed] [Google Scholar]
  20. Stone L. A., Frank J. A., Albert P. S., Bash C. N., Calabresi P. A., Maloni H., McFarland H. F. Characterization of MRI response to treatment with interferon beta-1b: contrast-enhancing MRI lesion frequency as a primary outcome measure. Neurology. 1997 Sep;49(3):862–869. doi: 10.1212/wnl.49.3.862. [DOI] [PubMed] [Google Scholar]
  21. Stone L. A., Frank J. A., Albert P. S., Bash C., Smith M. E., Maloni H., McFarland H. F. The effect of interferon-beta on blood-brain barrier disruptions demonstrated by contrast-enhanced magnetic resonance imaging in relapsing-remitting multiple sclerosis. Ann Neurol. 1995 May;37(5):611–619. doi: 10.1002/ana.410370511. [DOI] [PubMed] [Google Scholar]
  22. Stüve O., Dooley N. P., Uhm J. H., Antel J. P., Francis G. S., Williams G., Yong V. W. Interferon beta-1b decreases the migration of T lymphocytes in vitro: effects on matrix metalloproteinase-9. Ann Neurol. 1996 Dec;40(6):853–863. doi: 10.1002/ana.410400607. [DOI] [PubMed] [Google Scholar]
  23. Thompson A. J., Miller D., Youl B., MacManus D., Moore S., Kingsley D., Kendall B., Feinstein A., McDonald W. I. Serial gadolinium-enhanced MRI in relapsing/remitting multiple sclerosis of varying disease duration. Neurology. 1992 Jan;42(1):60–63. doi: 10.1212/wnl.42.1.60. [DOI] [PubMed] [Google Scholar]
  24. Truyen L., van Waesberghe J. H., van Walderveen M. A., van Oosten B. W., Polman C. H., Hommes O. R., Adèr H. J., Barkhof F. Accumulation of hypointense lesions ("black holes") on T1 spin-echo MRI correlates with disease progression in multiple sclerosis. Neurology. 1996 Dec;47(6):1469–1476. doi: 10.1212/wnl.47.6.1469. [DOI] [PubMed] [Google Scholar]
  25. Uhlenbrock D., Sehlen S. The value of T1-weighted images in the differentiation between MS, white matter lesions, and subcortical arteriosclerotic encephalopathy (SAE). Neuroradiology. 1989;31(3):203–212. doi: 10.1007/BF00344344. [DOI] [PubMed] [Google Scholar]
  26. van Buchem M. A., McGowan J. C., Kolson D. L., Polansky M., Grossman R. I. Quantitative volumetric magnetization transfer analysis in multiple sclerosis: estimation of macroscopic and microscopic disease burden. Magn Reson Med. 1996 Oct;36(4):632–636. doi: 10.1002/mrm.1910360420. [DOI] [PubMed] [Google Scholar]
  27. van Walderveen M. A., Barkhof F., Hommes O. R., Polman C. H., Tobi H., Frequin S. T., Valk J. Correlating MRI and clinical disease activity in multiple sclerosis: relevance of hypointense lesions on short-TR/short-TE (T1-weighted) spin-echo images. Neurology. 1995 Sep;45(9):1684–1690. doi: 10.1212/wnl.45.9.1684. [DOI] [PubMed] [Google Scholar]
  28. van Walderveen M. A., Kamphorst W., Scheltens P., van Waesberghe J. H., Ravid R., Valk J., Polman C. H., Barkhof F. Histopathologic correlate of hypointense lesions on T1-weighted spin-echo MRI in multiple sclerosis. Neurology. 1998 May;50(5):1282–1288. doi: 10.1212/wnl.50.5.1282. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES