The recently concluded 68th annual meeting of the American Academy of Neurology was the venue of the world’s first study investigating the effect of smoking on brain volume in patients with multiple sclerosis. The study was presented by Navid Seraji-Bozorgzad, M.D., assistant professor of Neurology and associate director of the Sastry Foundation Advanced Imaging Laboratory for the Wayne State University School of Medicine.
The study examined the brain volume of several hundred patients with MS, using fully automated software called SIENA. One group of patients continued to smoke while one group stopped smoking. Brain volume was measured periodically in both groups using a 3T magnetic resonance imaging scanner.
“The results were striking because patients who stopped smoking had significant deceleration in brain volume loss almost approaching the rate of brain volume loss in age-matched healthy adults,” Dr. Seraji-Bozorgzad said. “Furthermore, patients who did not stop smoking continued to demonstrate brain volume loss, which was significantly greater than the patients who stopped smoking.”
Dr. Seraji-Bozorgzad said loss of brain volume in MS usually occurs at two to three times the rate of age-matched healthy controls. It is a predictor of disability in MS and a main focus of therapeutic development.
Dr. Omar Khan, professor and chair, and director of the Multiple Sclerosis Center and the Sastry Advanced Imaging Laboratory, who was the study’s co-principal investigator, said that the study provides several key messages. First, all MS patients should be actively counseled against smoking. The perils of smoking are well known, but this new biologic evidence that cessation of smoking may restore “brain health by reducing loss of brain volume is vital information.” Second, smoking should be considered as a covariate in MS studies as it may affect the outcomes of clinical trials. Further studies are needed to examine the effect of smoking on grey matter atrophy separate from white matter atrophy in MS.
Multiple sclerosis is an immune-mediated disorder of the central nervous system. Emerging data emphasizes the role of B cells in the disease pathophysiology. More than 500,000 Americans are affected by MS.
Wayne State University has one of the largest MS clinics in the country with key focus on translational research as well as the relationship between MS disease biology and ethnicity. Wayne State University has the largest African-American MS clinic in the United States.