No evidence of disease activity in multiple sclerosis: Implications on cognition and brain atrophy

Autor(es)

Damasceno, Alfredo ^[1] ; Damasceno, Benito Pereira ^[1] ; Cendes, Fernando ^[1]

Afiliação do(s) autor(es)

^[1] Univ Estadual Campinas, UNICAMP, Dept Neurol, Campinas, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: MULTIPLE SCLEROSIS; v. 22, n. 1, p. 64-72, JAN 2016.
• Citações Web of Science: 31

Resumo

Background: The concept of no evidence of disease activity (NEDA) has emerged as an important outcome measure for multiple sclerosis (MS). However, it is not known if maintaining NEDA has a positive impact on cognition or brain atrophy. Objective: To evaluate NEDA status after two years, addressing its implications on cognition and brain atrophy. Methods: Forty-two relapsing-remitting MS patients and 30 controls underwent MRI (3T) and cognitive evaluation (BRB-N). Forty patients performed additional evaluations, after 12 and 24 months. NEDA was defined as the absence of clinical (relapses/disability progression) and MRI activity (new T2/gadolinium-enhancing lesions). Repeated measures and multivariate analyses were performed to assess the contribution of NEDA criteria to GM atrophy. Results: After two years, 30.8% of the cohort had NEDA. From these, 58.3% still had worsening in 2 cognitive domains. Patients with MRI activity had more cortical thinning and slightly more thalamus volume decrease. Absence of new/enlarging T2 lesions was the only predictor of cortical thinning, subcortical GM and thalamic atrophy rates. Conclusions: NEDA status was achieved in a small proportion of our cohort, and did not preclude cognitive deterioration. Absence of MRI activity and especially of new/enlarging T2 lesions was associated with less cortical and subcortical GM atrophy. (AU)

• Processo FAPESP: 10/00885-4 - Avaliação longitudinal da atrofia cerebral e espessura cortical e sua relação com fatores clínicos e imunológicos em pacientes com esclerose múltipla
• Beneficiário: Alfredo Damasceno
• Modalidade de apoio: Bolsas no Brasil - Doutorado Direto