Active brain changes after initiating fingolimod therapy in multiple sclerosis patients using individual voxel-based analyses for diffusion tensor imaging.

• DOI: 10.18999/nagjms.78.4.455
• Publication Date: 2016-12-01
• Authors: Joe Senda; Hirohisa Watanabe; Kuniyuki Endo; Keizo Yasui; Yasuhiro Hawsegawa; Noritaka Yoneyama; Takashi Tsuboi; Kazuhiro Hara; Mizuki Ito; Masashi Aoki; Bagarinao Epifanio; Masahisa Katsuno; Shinji Naganawa; Gen Sobue
• Keywords: Fluid-attenuated inversion recovery; Voxel-based morphometry

Voxel-based analysis (VBA) of diffusion tensor images (DTI) and voxel-based morphometry (VBM) in patients with multiple sclerosis (MS) can sensitively detect occult tissue damage that underlies pathological changes the brain. In present study, both at start fingolimod post-four months clinical remission, we assessed four MS who were evaluated VBA DTI, VBM, fluid-attenuated inversion recovery (FLAIR). DTI for all showed widespread areas increased mean diffusivity (MD) decreased fractional anisotropy (FA) beyond high-intensity signal across images. After continuous therapy, abnormalities progressed; particular, MD was significantly increased, while brain volume signals unchanged. These findings suggest (e.g., MD) may help assess demyelination as neuroinflammatory conditions, even though manifestations appear to be complete remission during fingolimod.