This is the version as published in the Journal of Neurol Neurosurgery Psychiatry\ud http://jnnp.bmj.com/Objective—Recently, a strong correlation\ud between the increase in hypointense lesion\ud load on T1 weighted spin echo images, and\ud the increase in disability was reported.\ud Although the effect of interferon-â has\ud been demonstrated both in reducing exacerbation rate, frequency of enhancing\ud lesions, and accumulation of disease burden\ud on T2 weighted images, the impact on the accumulation of hypointense lesions has not yet been evaluated. The aims of the present study were: (a) to assess for the first time the effect of interferon-â-1a on T1 weighted MRI hypointense lesion volume; and (b) to evaluate the relation between changes on hypointense, hyperintense, and enhancing lesion volume before and during interferon-â-1a treatment in relapsing-remitting multiple sclerosis.\ud Methods—After a baseline scan and 6\ud month pretreatment period, 67 patients\ud with relapsing-remitting multiple sclerosis\ud were treated with interferon-â-1a by\ud subcutaneous injection three times a week\ud during a 12 month treatment period. All\ud patients had MRI every month during the\ud 6 month pretreatment period and for the\ud first 9 months of the treatment period. A\ud final MRI was also performed at the end of\ud the 12 month treatment period.\ud Results—There was a significant increase\ud in the mean hyperintense lesion volume\ud during the pretreatment phase (6 months)\ud and a slight decrease during the treatment\ud period (12 months), whereas the hypointense\ud lesion volume increased significantly\ud before treatment and remained\ud substantially stable during treatment.\ud There was a significant correlation between\ud changes in hypointense and hyperintense\ud lesion volume during the observation period, but not during treatment. The monthly mean volume of Gadolinium-DTPA enhancing lesions was significantly higher during the pretreatment than the treatment period, and the enhancing lesion volume correlated with\ud changes of hyperintense and hypointense\ud lesion volumes only during the observation\ud period.\ud Conclusion—These data suggest that\ud interferon-â-1a has a stabilising effect on\ud T1 weighted hypointense lesion volume
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