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378497 tn?1232143585

Some folks might be interested: about black holes

http://jnnp.bmj.com/cgi/content/short/jnnp.2008.171090v1?q=w_jnnp_ahead_tab

Layperson's summary: Treatment with glatiramer acetate or the interferon may limit the number of new black holes that became permanent; i.e., reduce progression of brain atrophy, and the interferon seemed to be slightly better at it. There is no control (i.e., untreated) group for comparison of how well the ************** worked vs. no treatment at all.

New acute and chronic black holes in multiple sclerosis patients randomized to interferon beta-1b or glatiramer acetate
Diego Cadavid 1*, Jojy Cheriyan 1, Joan Skurnick 1, John A Lincoln 1, Leo J Wolansky 1 and Stuart D Cook 1
1 UMDNJ-New Jersey Medical School, United States
To whom correspondence should be addressed. E-mail: ***@****.

Abstract
Background: Hypointense lesions on T1 weighted MRI, referred to as black holes (BH), are a marker of demyelination/axonal loss in multiple sclerosis (MS). There is some evidence that glatiramer acetate (GA) may decrease the conversion of new brain lesions to BH.

Methods: We used monthly 3 Tesla brain MRI scans for up to 2 years to study the development and evolution of new BH in 75 MS patients randomized to GA or Interferon {beta}-1b (IFNb1b) in the BECOME study.

Findings: Of 1,224 newly enhancing lesions (NEL) appearing at baseline through 24 months in 61 patients, 767 (62•7%) showed an acute BH( ABH). The majority of ABH were transient and of similar duration by treatment group. Of 571 ABH in which MRI follow-up scans were available for ≥1 year, 103 (18.8%) were still visible ≥12 months after onset and were considered chronic BH (CBH). Only 12.1% of the 849 NEL with MRI follow-up ≥1 year converted to CBH, 9.8% with IFN{beta}1b and 15.2•% with GA (p=0•02). The conversion from ABH to CBH was also lower with IFN{beta}1b (15.2%) than with GA (21•4%), of borderline significance (p=0.06). The majority of patients who developed NEL did not develop CBH; however, about a quarter had conversion rates from ABH to CBH greater than 20%.

Interpretation: Only a minority of new brain lesions in MS patients treated with GA or IFN{beta}1b convert to CBH.
7 Responses
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382218 tn?1341181487
I thought the same thing as you Ess, in fact specifically I thought of you, knowing of your interest in the other black holes!

Really interesting, thanks for posting Bio.

An average of 20 newly enhancing lesions per subject?  Is my math right?  That's a whole lotta lesions.

Helpful - 0
378497 tn?1232143585
Shell, I guess it would have been unethical to have an untreated group given that they know these drugs help in other ways.

Bio
Helpful - 0
198419 tn?1360242356
Haven't peeked at the links yet, but thank you for this Bio - always keeping my ear open on T1 Hypo's.  Though I don't understand why no control group...

Thanks!
shell
Helpful - 0
739070 tn?1338603402
Thanks for the info.  Good news regarding the black hole conversion rate.

Ren
Helpful - 0
572651 tn?1530999357
I've given up on trying to second guess the **** workings around here.  The email address got the *** because that's how the program is set up - anything that has the *at* sign will get bleeped.  

thanks for the BH info - I have several and I'm always wondering what the deal is with them  Some say they heal and disappear.  Others say they become permanent.  Obviously they can do either but not both!  

I especially appreciate your translation - I don't speak researchese very well.

Lulu
Helpful - 0
378497 tn?1232143585
I can't even remember what that word was that they asterisked out, but I think it was "treatment" or "experimental" or something like that. Why would they asterisk that out?

Bio
Helpful - 0
Avatar universal
Thanks, Bio. I'm quite interested in cosmology, so you can imagine what black holes I at first thought you were referring to!

Not that that makes any sense on an MS site, but still it's good that I don't have MS on my mind 24/7.

ess
Helpful - 0
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