title: White Matter Diffusion Changes during the First Year of Natalizumab Treatment in Relapsing-Remitting Multiple Sclerosis.
abstract: Natalizumab treatment strongly affects relapsing-remitting multiple sclerosis, possibly by restraining white matter damage. This study investigated changes in white matter diffusivity in patients with relapsing-remitting multiple sclerosis during their first year of natalizumab treatment by using diffusion tensor imaging.
  
  
  
  The study included patients with relapsing-remitting multiple sclerosis initiating natalizumab at baseline (n = 22), patients with relapsing-remitting multiple sclerosis continuing interferon-β or glatiramer acetate (n = 17), and healthy controls (n = 12). Diffusion tensor imaging parameters were analyzed at baseline and month 12. We measured the extent and severity of white matter damage with diffusion tensor imaging parameters such as fractional anisotropy, comparing the patient groups with healthy controls at both time points.
  
  
  
  The extent and severity of white matter damage were reduced significantly in the natalizumab group with time (fractional anisotropy-based extent, 56.8% to 47.2%; severity, z = -0.67 to -0.59; P = .02); this reduction was not observed in the interferon-β/glatiramer acetate group (extent, 41.4% to 39.1%, and severity, z = -0.64 to -0.67; P = .94). Cognitive performance did not change with time in the patient groups but did correlate with the severity of damage (r = 0.53, P = < .001).
  
  
  
  In patients with relapsing-remitting multiple sclerosis starting natalizumab treatment, the extent and severity of white matter damage were reduced significantly in the first year of treatment. These findings may aid in explaining the large observed clinical effect of natalizumab in relapsing-remitting multiple sclerosis.
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (O.T.W., G.J.A.N., M.D.S., F.B.) Anatomy and Neurosciences (O.T.W., M.M.S., H.E.H., G.J.A.N., J.J.G.G.) o.wiebenga@vumc.nl.
authors.forename: O T
authors.identifier: 0000-0002-6429-1973
authors.initials: OT
authors.lastname: Wiebenga
authors.affiliation: Anatomy and Neurosciences (O.T.W., M.M.S., H.E.H., G.J.A.N., J.J.G.G.).
authors.forename: M M
authors.identifier: 0000-0002-2504-6959
authors.initials: MM
authors.lastname: Schoonheim
authors.affiliation: Anatomy and Neurosciences (O.T.W., M.M.S., H.E.H., G.J.A.N., J.J.G.G.).
authors.forename: H E
authors.identifier: 0000-0002-5039-1359
authors.initials: HE
authors.lastname: Hulst
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (O.T.W., G.J.A.N., M.D.S., F.B.) Anatomy and Neurosciences (O.T.W., M.M.S., H.E.H., G.J.A.N., J.J.G.G.).
authors.forename: G J A
authors.initials: GJ
authors.lastname: Nagtegaal
authors.affiliation: Neurology (E.M.M.S., C.H.P.).
authors.forename: E M M
authors.identifier: 0000-0001-6705-5864
authors.initials: EM
authors.lastname: Strijbis
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (O.T.W., G.J.A.N., M.D.S., F.B.).
authors.forename: M D
authors.identifier: 0000-0002-8346-9044
authors.initials: MD
authors.lastname: Steenwijk
authors.affiliation: Neurology (E.M.M.S., C.H.P.).
authors.forename: C H
authors.identifier: 0000-0002-9253-1743
authors.initials: CH
authors.lastname: Polman
authors.affiliation: Physics and Medical Technology (P.J.W.P.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: P J W
authors.identifier: 0000-0001-8430-0606
authors.initials: PJ
authors.lastname: Pouwels
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (O.T.W., G.J.A.N., M.D.S., F.B.).
authors.forename: F
authors.identifier: 0000-0003-3543-3706
authors.initials: F
authors.lastname: Barkhof
authors.affiliation: Anatomy and Neurosciences (O.T.W., M.M.S., H.E.H., G.J.A.N., J.J.G.G.).
authors.forename: J J G
authors.identifier: 0000-0003-1896-3748
authors.initials: JJ
authors.lastname: Geurts
mesh_terms: D000328:Adult; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D000068717:Glatiramer Acetate / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D016899:Interferon-beta / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000069442:Natalizumab / Q000627:therapeutic use*; D066127:White Matter / Q000000981:diagnostic imaging / Q000187:drug effects*
chemical_list: D007155:Immunologic Factors; D000069442:Natalizumab; D000068717:Glatiramer Acetate; D016899:Interferon-beta