[Evaluation of the effect of highly effective multiple sclerosis disease-modifying drugs on the progression of the disease using diffusion-weighted magnetic resonance imaging with tractography].

[Evaluation of the effect of highly effective multiple sclerosis disease-modifying drugs on the progression of the disease using diffusion-weighted magnetic resonance imaging with tractography].

OBJECTIVE

To study the effect of highly effective multiple sclerosis disease-modifying drugs (ocrelizumab and cladribine) on the course of the disease using diffusion-weighted MRI with tractography.

MATERIALS AND

METHODS

The study included 23 patients divided into two groups: Group 1 received cladribine, and Group 2 received ocrelizumab. To assess the severity of damage to the pyramidal tract and the effectiveness of treatment, all patients underwent dynamic brain MRI with tractography before the start of therapy (baseline) and one year after the start of treatment.

RESULTS

The comparison of the results of the examination of the participants of group 1 with the indicators of the control group did not show significant differences in the volume of the pyramidal tract, FA, and ADC. Analysis of results one year after starting ocrelizumab treatment showed a statistically significant increase in ADC, while other parameters showed no significant change.

CONCLUSION

The comparison of the examination results of group 1 patients with those in the control group showed a decrease in the length of the pyramidal tract. However, there was no difference between the values before and after treatment. These results suggest that cladribine therapy contributes to slowing down neurodegenerative processes. Analysis of the results one year after the start of treatment with ocrelizumab showed a slight negative trend, indicating the progression of neurodegenerative processes. The observed results are probably due to more severe baseline impairment of the pyramidal function and ambulation in this group of patients compared to group 1.