Axonal Degeneration Independent of Inflammatory Activity: Is It More Intense in the Early Stages of Relapsing-Remitting Multiple Sclerosis Disease?
- 1 November 2020
- journal article
- research article
- Published by S. Karger AG in European Neurology
- Vol. 83 (5), 508-516
- https://doi.org/10.1159/000510116
Abstract
Background: This study aimed to investigate whether there are differences in the axonal degeneration rate between patients in the early years of relapsing-remitting multiple sclerosis (RRMS) disease and RRMS patients in their later years. Methods: The early-stage RRMS patients (EMS) group had 65 patients whose duration of disease was within 3 years from the date of the first attack. The late-stage RRMS patients (LMS) group had 69 patients whose duration of disease was within the range of 3-10 years from the date of the first attack. In addition, a control group was composed of 32 healthy subjects. Peripapillary retinal nerve fiber layer (RNFL) thickness was monitored with spectral-domain OCT in all included patients for approximately 3 years. Results: The annual RNFL atrophy rate (aRNFLr) in the EMS group was -1.246 +/- 0.778 mu m/year, the aRNFLr in the LMS group was -0.898 +/- 0.536 mu m/year, and the aRNFLr was -0.234 +/- 0.154 mu m/year in the control group (p < 0.001). The aRNFLr in the EMS group was significantly higher than the aRNFLr in the LMS group (p = 0.01). The aRNFLr was not associated with MRI activity or the condition of having an attack. There was a correlation between Expanded Disability Status Scale (EDSS) progression and aRNFLr in both the EMS and LMS patient groups (r = -0.471, p < 0.001, and r = -0.567, p < 0.001, respectively). Conclusion: The axonal degeneration rate is faster in RRMS patients in the first years of the disease than in later years. In addition, axonal degeneration occurs independently of inflammatory activity. Axonal degeneration is correlated with disability progression, but not with inflammatory findings, such as clinical episodes and MRI activity.Keywords
This publication has 24 references indexed in Scilit:
- Retinal nerve fiber layer thickness in benign multiple sclerosisMultiple Sclerosis Journal, 2013
- Tract-specific quantitative MRI better correlates with disability than conventional MRI in multiple sclerosisZeitschrift für Neurologie, 2012
- Will the real multiple sclerosis please stand up?Nature Reviews Neuroscience, 2012
- Progressive Multiple Sclerosis and Gray Matter Pathology: An MRI PerspectiveMount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine, 2011
- Cerebral pseudoatrophy or real atrophy after therapy in multiple sclerosisAnnals of Neurology, 2010
- Damage to the Optic Radiation in Multiple Sclerosis Is Associated With Retinal Injury and Visual DisabilityArchives of Neurology, 2009
- Differences in retinal nerve fiber layer atrophy between multiple sclerosis subtypesJournal of the Neurological Sciences, 2009
- Multiple Sclerosis: An Immune or Neurodegenerative Disorder?Annual Review of Neuroscience, 2008
- Magnetization transfer MRI metrics predict the accumulation of disability 8 years later in patients with multiple sclerosisBrain, 2006
- Biomarkers and Surrogate Outcomes in Neurodegenerative Disease: Lessons from Multiple SclerosisNeuroRX, 2004