Advanced imaging in lesion and normal-appearing white matter over 2 years in MS patients treated with alemtuzumab (S29.009)
Bibliographic record
Abstract
OBJECTIVE: Pathologically, multiple sclerosis (MS) is characterized by focal tissue injury of the CNS. Alemtuzumab is an MS therapy designed to inhibit inflammation and prevent the accumulation of disability. To test the potential neuroprotective properties of the drug, we used advanced magnetic resonance imaging (MRI) techniques to measure water content, demyelination and remyelination in vivo. BACKGROUND: To use MRI to monitor changes in myelin water fraction (MWF, a marker of myelin) and T1 (related to water content) within lesions and normal-appearing white matter (NAWM) over 2 years in patients treated with alemtuzumab. DESIGN/METHODS: Nineteen patients were imaged every 6 months for 2 years on a 3T Philips MR scanner. Patients were treated with alemtuzumab at baseline and 12 months. Myelin water fraction and T1 were measured in NAWM and lesions. RESULTS: 46 new lesions were detected in 15 patients (28 within the 1st 6 months). NAWM and chronic lesion measures remained stable over time. New lesions, on average, showed a decrease in MWF at first appearance (8[percnt] to 5[percnt]). New lesions that appeared after 6 months from baseline showed a trend for greater MWF recovery compared to lesions that appeared within 6 months of treatment start (6.3[percnt] vs 5.2[percnt]). The increased T1 observed upon lesion appearance was smaller for lesions which appeared after 6 months of treatment compared to lesions that appeared within 6 months of treatment (1.1s vs 1.3s,p=0.001). CONCLUSIONS: Remyelination, indicated by increased MWF, appeared to be more robust possibly due to an improved immunologic milieu post-alemtuzumab. Supporting this is a smaller T1 increase at new lesion appearance indicating less edema and inflammation for lesions formed while under the effects of alemtuzumab. The marked decrease in new lesion formation after 6 months supports the enduring beneficial effects of alemtuzumab in MS patients. Study Supported by: Genzyme Corporation
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".