Brain network alteration was associated with 'no evidence of disease activity' status in patients with relapsing-remitting multiple sclerosis.

Background: The associations between the monthly rate of topological property change (mrTPC) in the structural and functional connectivity network (SCN, FCN) and achieving no evidence of disease activity (NEDA) in relapsing-remitting multiple sclerosis (RRMS) patients taking oral disease-modifying therapies (DMTs) remain insufficiently explored.

Methods: This was a retrospective study conducted with RRMS patients treated with oral DMTs or untreated between January 2019 and June 2023. All participants underwent baseline and follow-up clinical evaluations and MRI scans. Initially, NEDA statuses of all participants were assessed. Then, the mrTPCs from SCN and FCN were calculated. Finally, the baseline characteristics and mrTPCs were inserted into logistic regression models to explore their associations with achieving NEDA status.

Results: A total of 58 RRMS patients were included, with 46 in the treated group and 12 in the untreated group. A greater percentage of treated RRMS patients achieved NEDA3+ (60.87 % vs. 25.00 %) or NEDA4+ (21.74 % vs. 8.33 %) statuses. Patients with oral DMTs (P = 0.032) and lower contrast-enhancing lesions (CELs) count (P = 0.009) were more likely to achieve NEDA3+ status. Nomograms based on the mrTPCs revealed SCN_NLe_SMA.R (P = 0.042) and FCN_NLe_PCL.L (P = 0.050) were significant for the NEDA3 or NEDA 4 model. Both the above models performed well (AUC: 0.756 and 0.722, respectively).

Conclusions: Specifically altered mrTPC was linked to NEDA status in RRMS patients on oral DMTs. Although the specific mechanisms for each NEDA status may differ and need further investigation, these findings can help clinicians personalize RRMS treatment and monitoring.