White matter lesion volumes on 3-T MRI in people with MS who had followed a diet- and lifestyle program for more than 10 years

Abstract

Background: Cerebral white matter lesions (WMLs) in people with multiple sclerosis (pwMS) are associated with the death of myelin-producing oligodendrocytes. MS treatment strategies aim to limit WML accumulation and disability progression. It is commonly accepted that nutrition is one of the possible environmental factors involved in the pathogenesis of MS, but its role as a complementary MS treatment is unclear and, to a large extent, ignored. Objective: A pilot case control study over a 10 year period to ascertain whether a dietary- and lifestyle modification Program in pwMS reduces or prevents WML formation. Methods: MRI was performed at baseline and after an interval period of at least 10 years or longer in 22 pwMS. WML volumes were determined using Sequence Adaptive Multimodal SEGmentation (SAMSEG) software, part of FreeSurfer 7.2. Other variables include age at MRI, disease duration, disability status and medication. Results: PwMS (n=13) who had followed the Program for more than 10 years, had significantly smaller lesion volumes (mm3) compared to pwMS who did not adhere to the Program (n=9) (4950 ± 5303 vs 17934 ± 11139; p=0.002). WML volumes were significantly associated (p=0.02) with disability (EDSS) but not with age (p=0.350), disease duration (p=0.709), or Interferon-β treatment (p=0.70). Conclusion: Dietary- and ± changes may lower the risk of developing cerebral WMLs in pwMS and potentially slow down disease progression. Larger studies are required to confirm the effectiveness of such interventions in pwMS.