title: Quantitative MRI and cerebrospinal fluid inflammatory mediators in Brazilian patients with relapsing-remitting multiple sclerosis before and after treatment with immunomodulators: a longitudinal study.
abstract: OBJECTIVE
  The pathological hallmarks of multiple sclerosis (MS) lesions are inflammation, demyelination, axon loss and gliosis. The aim of this study was to verify the relation of brain lesion load and volume of the cerebral hemisphere determined by brain MRI with intrathecal antibody synthesis.
  
  
  METHODS
  A longitudinal study of 54 Brazilian patients with the relapsing-remitting form of MS was undertaken after an average of 6.3 ± 2.7 years of treatment. MRI scans were performed, and cerebrospinal fluid samples were collected both during the diagnostic process and after treatment with β-interferon or glatiramer acetate.
  
  
  RESULTS
  A positive correlation between the IgG index and total lesion volume was identified. Intrathecal IgG against Epstein-Barr virus (EBV) was observed in 21 patients. The number of contrast-enhanced lesions observed in these patients was correlated with intrathecal IgM synthesis. Brain atrophy was observed early in the disease, with the number of relapses inversely correlated with brain volume.
  
  
  CONCLUSIONS
  The high intrathecal IgG synthesis observed in these relapsing-remitting MS patients is associated with the brain lesion burden and the presence of antibodies to EBV, whereas intrathecal IgM synthesis is associated with the activity of the disease, as revealed by MRI.
authors.affiliation: Neuroimmunology Unit, Department of Genetics, Evolution and Bioagents, UNICAMP, Campinas, Brazil.
authors.forename: Heloisa H
authors.initials: HH
authors.lastname: Ruocco
authors.forename: Carlos Otavio
authors.initials: CO
authors.lastname: Brandão
authors.forename: Alessandro S
authors.initials: AS
authors.lastname: Farias
authors.forename: Celina
authors.initials: C
authors.lastname: Oliveira
authors.forename: Elaine C
authors.initials: EC
authors.lastname: Oliveira
authors.forename: Fernando
authors.initials: F
authors.lastname: Cendes
authors.forename: Benito P
authors.initials: BP
authors.lastname: Damasceno
authors.forename: Leonilda M B
authors.initials: LM
authors.lastname: Santos
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D002648:Child; D004185:Disability Evaluation; D005260:Female; D000068717:Glatiramer Acetate; D006801:Humans; D007136:Immunoglobulins / Q000134:cerebrospinal fluid*; D007155:Immunologic Factors / Q000627:therapeutic use*; D016899:Interferon-beta / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000473:pathology; D010455:Peptides / Q000627:therapeutic use*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D007136:Immunoglobulins; D007155:Immunologic Factors; D010455:Peptides; D000068717:Glatiramer Acetate; D016899:Interferon-beta