TY - JOUR T1 - A Three-Year Study of Brain Atrophy after Autologous Hematopoietic Stem Cell Transplantation in Rapidly Evolving Secondary Progressive Multiple Sclerosis JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 1659 LP - 1661 DO - 10.3174/ajnr.A0644 VL - 28 IS - 9 AU - M.A. Rocca AU - T. Mondria AU - P. Valsasina AU - M.P. Sormani AU - Z.H. Flach AU - P.A. Te Boekhorst AU - G. Comi AU - R.Q. Hintzen AU - M. Filippi Y1 - 2007/10/01 UR - http://www.ajnr.org/content/28/9/1659.abstract N2 - BACKGROUND AND PURPOSE: In multiple sclerosis (MS), autologous hematopoietic stem cell transplantation (AHSCT) induces a profound suppression of clinical activity and MR imaging-detectable inflammation, but it may be associated with a rapid brain volume loss in the months subsequent to treatment. The aim of this study was to assess how AHSCT affects medium-term evolution of brain atrophy in MS.MATERIALS AND METHODS: MR imaging scans of the brain from 14 patients with rapidly evolving secondary-progressive MS obtained 3 months before and every year after AHSCT for 3 years were analyzed. Baseline normalized brain volumes and longitudinal percentage of brain volume changes (PBVCs) were assessed using the Structural Image Evaluation of Normalized Atrophy software.RESULTS: The median decrease of brain volume was 1.92% over the first year after AHSCT and then declined to 1.35% at the second year and to 0.69% at the third year. The number of enhancing lesions seen on the pretreatment scans was significantly correlated with the PBVCs between baseline and month 12 (r = −0.62; P = .02); no correlation was found with the PBVCs measured over the second and third years.CONCLUSIONS: After AHSCT, the rate of brain tissue loss in patients with MS declines dramatically after the first 2 years. The initial rapid development of brain atrophy may be a late consequence of the pretransplant disease activity and/or a transient result of the intense immunoablative conditioning procedure. ER -