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<meta name="DC.Title" content="White Matter Diffusion Changes during the First Year of Natalizumab Treatment in Relapsing-Remitting Multiple Sclerosis" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4690" />
<meta name="DC.Date" content="2016-06-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2016 by American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Natalizumab treatment strongly affects relapsing-remitting multiple sclerosis, possibly by restraining white matter damage. This study investigated changes in white matter diffusivity in patients with relapsing-remitting multiple sclerosis during their first year of natalizumab treatment by using diffusion tensor imaging.

MATERIALS AND METHODS: The study included patients with relapsing-remitting multiple sclerosis initiating natalizumab at baseline ( n = 22), patients with relapsing-remitting multiple sclerosis continuing interferon-β or glatiramer acetate ( n = 17), and healthy controls ( n = 12). Diffusion tensor imaging parameters were analyzed at baseline and month 12. We measured the extent and severity of white matter damage with diffusion tensor imaging parameters such as fractional anisotropy, comparing the patient groups with healthy controls at both time points.

RESULTS: The extent and severity of white matter damage were reduced significantly in the natalizumab group with time (fractional anisotropy–based extent, 56.8% to 47.2%; severity, z = −0.67 to −0.59; P = .02); this reduction was not observed in the interferon-β/glatiramer acetate group (extent, 41.4% to 39.1%, and severity, z = −0.64 to −0.67; P = .94). Cognitive performance did not change with time in the patient groups but did correlate with the severity of damage ( r = 0.53, P = &lt; .001).

CONCLUSIONS: In patients with relapsing-remitting multiple sclerosis starting natalizumab treatment, the extent and severity of white matter damage were reduced significantly in the first year of treatment. These findings may aid in explaining the large observed clinical effect of natalizumab in relapsing-remitting multiple sclerosis.

AD
:   axial diffusivity
EDSS
:   Expanded Disability Status Scale
FA
:   fractional anisotropy
GA
:   glatiramer acetate
IFNb
:   interferon β
NBV
:   normalized whole-brain volume
MD
:   mean diffusivity
RCI
:   Reliable Change Index
RD
:   radial diffusivity
RRMS
:   relapsing-remitting multiple sclerosis" />
<meta name="DC.Contributor" content="O.T. Wiebenga" />
<meta name="DC.Contributor" content="M.M. Schoonheim" />
<meta name="DC.Contributor" content="H.E. Hulst" />
<meta name="DC.Contributor" content="G.J.A. Nagtegaal" />
<meta name="DC.Contributor" content="E.M.M. Strijbis" />
<meta name="DC.Contributor" content="M.D. Steenwijk" />
<meta name="DC.Contributor" content="C.H. Polman" />
<meta name="DC.Contributor" content="P.J.W. Pouwels" />
<meta name="DC.Contributor" content="F. Barkhof" />
<meta name="DC.Contributor" content="J.J.G. Geurts" />
<meta name="article:published_time" content="2016-06-01" />
<meta name="article:section" content="ADULT BRAIN" />
<meta name="citation_title" content="White Matter Diffusion Changes during the First Year of Natalizumab Treatment in Relapsing-Remitting Multiple Sclerosis" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Natalizumab treatment strongly affects relapsing-remitting multiple sclerosis, possibly by restraining white matter damage. This study investigated changes in white matter diffusivity in patients with relapsing-remitting multiple sclerosis during their first year of natalizumab treatment by using diffusion tensor imaging.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;The study included patients with relapsing-remitting multiple sclerosis initiating natalizumab at baseline (&lt;i&gt;n&lt;/i&gt; = 22), patients with relapsing-remitting multiple sclerosis continuing interferon-β or glatiramer acetate (&lt;i&gt;n&lt;/i&gt; = 17), and healthy controls (&lt;i&gt;n&lt;/i&gt; = 12). Diffusion tensor imaging parameters were analyzed at baseline and month 12. We measured the extent and severity of white matter damage with diffusion tensor imaging parameters such as fractional anisotropy, comparing the patient groups with healthy controls at both time points.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The extent and severity of white matter damage were reduced significantly in the natalizumab group with time (fractional anisotropy–based extent, 56.8% to 47.2%; severity, &lt;i&gt;z&lt;/i&gt; = −0.67 to −0.59; &lt;i&gt;P&lt;/i&gt; = .02); this reduction was not observed in the interferon-β/glatiramer acetate group (extent, 41.4% to 39.1%, and severity, &lt;i&gt;z&lt;/i&gt; = −0.64 to −0.67; &lt;i&gt;P&lt;/i&gt; = .94). Cognitive performance did not change with time in the patient groups but did correlate with the severity of damage (&lt;i&gt;r&lt;/i&gt; = 0.53, &lt;i&gt;P&lt;/i&gt; = &amp;lt; .001).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;In patients with relapsing-remitting multiple sclerosis starting natalizumab treatment, the extent and severity of white matter damage were reduced significantly in the first year of treatment. These findings may aid in explaining the large observed clinical effect of natalizumab in relapsing-remitting multiple sclerosis.&lt;/p&gt;" />
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<meta name="twitter:title" content="White Matter Diffusion Changes during the First Year of Natalizumab Treatment in Relapsing-Remitting Multiple Sclerosis" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Natalizumab treatment strongly affects relapsing-remitting multiple sclerosis, possibly by restraining white matter damage. This study investigated changes in white matter diffusivity in patients with relapsing-remitting multiple sclerosis during their first year of natalizumab treatment by using diffusion tensor imaging.

MATERIALS AND METHODS: The study included patients with relapsing-remitting multiple sclerosis initiating natalizumab at baseline ( n = 22), patients with relapsing-remitting multiple sclerosis continuing interferon-β or glatiramer acetate ( n = 17), and healthy controls ( n = 12). Diffusion tensor imaging parameters were analyzed at baseline and month 12. We measured the extent and severity of white matter damage with diffusion tensor imaging parameters such as fractional anisotropy, comparing the patient groups with healthy controls at both time points.

RESULTS: The extent and severity of white matter damage were reduced significantly in the natalizumab group with time (fractional anisotropy–based extent, 56.8% to 47.2%; severity, z = −0.67 to −0.59; P = .02); this reduction was not observed in the interferon-β/glatiramer acetate group (extent, 41.4% to 39.1%, and severity, z = −0.64 to −0.67; P = .94). Cognitive performance did not change with time in the patient groups but did correlate with the severity of damage ( r = 0.53, P = &lt; .001).

CONCLUSIONS: In patients with relapsing-remitting multiple sclerosis starting natalizumab treatment, the extent and severity of white matter damage were reduced significantly in the first year of treatment. These findings may aid in explaining the large observed clinical effect of natalizumab in relapsing-remitting multiple sclerosis.

AD
:   axial diffusivity
EDSS
:   Expanded Disability Status Scale
FA
:   fractional anisotropy
GA
:   glatiramer acetate
IFNb
:   interferon β
NBV
:   normalized whole-brain volume
MD
:   mean diffusivity
RCI
:   Reliable Change Index
RD
:   radial diffusivity
RRMS
:   relapsing-remitting multiple sclerosis" />
<meta name="og-title" property="og:title" content="White Matter Diffusion Changes during the First Year of Natalizumab Treatment in Relapsing-Remitting Multiple Sclerosis" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/37/6/1030" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Natalizumab treatment strongly affects relapsing-remitting multiple sclerosis, possibly by restraining white matter damage. This study investigated changes in white matter diffusivity in patients with relapsing-remitting multiple sclerosis during their first year of natalizumab treatment by using diffusion tensor imaging.

MATERIALS AND METHODS: The study included patients with relapsing-remitting multiple sclerosis initiating natalizumab at baseline ( n = 22), patients with relapsing-remitting multiple sclerosis continuing interferon-β or glatiramer acetate ( n = 17), and healthy controls ( n = 12). Diffusion tensor imaging parameters were analyzed at baseline and month 12. We measured the extent and severity of white matter damage with diffusion tensor imaging parameters such as fractional anisotropy, comparing the patient groups with healthy controls at both time points.

RESULTS: The extent and severity of white matter damage were reduced significantly in the natalizumab group with time (fractional anisotropy–based extent, 56.8% to 47.2%; severity, z = −0.67 to −0.59; P = .02); this reduction was not observed in the interferon-β/glatiramer acetate group (extent, 41.4% to 39.1%, and severity, z = −0.64 to −0.67; P = .94). Cognitive performance did not change with time in the patient groups but did correlate with the severity of damage ( r = 0.53, P = &lt; .001).

CONCLUSIONS: In patients with relapsing-remitting multiple sclerosis starting natalizumab treatment, the extent and severity of white matter damage were reduced significantly in the first year of treatment. These findings may aid in explaining the large observed clinical effect of natalizumab in relapsing-remitting multiple sclerosis.

AD
:   axial diffusivity
EDSS
:   Expanded Disability Status Scale
FA
:   fractional anisotropy
GA
:   glatiramer acetate
IFNb
:   interferon β
NBV
:   normalized whole-brain volume
MD
:   mean diffusivity
RCI
:   Reliable Change Index
RD
:   radial diffusivity
RRMS
:   relapsing-remitting multiple sclerosis" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node14381--5" data-node-nid="14381" id="top-node-14381--61413507308" data-pisa="ajnr;37/6/1030" data-pisa-master="ajnr;ajnr.A4690" data-apath="/ajnr/37/6/1030.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">ADULT BRAIN</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">White Matter Diffusion Changes during the First Year of Natalizumab Treatment in Relapsing-Remitting Multiple Sclerosis</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">O.T. Wiebenga</span>, <span class="highwire-citation-author" data-delta="1">M.M. Schoonheim</span>, <span class="highwire-citation-author" data-delta="2">H.E. Hulst</span>, <span class="highwire-citation-author" data-delta="3">G.J.A. Nagtegaal</span>, <span class="highwire-citation-author" data-delta="4">E.M.M. Strijbis</span>, <span class="highwire-citation-author" data-delta="5">M.D. Steenwijk</span>, <span class="highwire-citation-author" data-delta="6">C.H. Polman</span>, <span class="highwire-citation-author" data-delta="7">P.J.W. Pouwels</span>, <span class="highwire-citation-author" data-delta="8">F. Barkhof</span> and <span class="highwire-citation-author" data-delta="9">J.J.G. Geurts</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">June 2016,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1030-1037; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4690 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14381--61413507308" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">O.T. Wiebenga </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology and Nuclear Medicine (O.T.W., G.J.A.N.<span class='nlm-sup'>†</span>, M.D.S., F.B.)</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Anatomy and Neurosciences (O.T.W., M.M.S., H.E.H., G.J.A.N.<span class='nlm-sup'>†</span>, J.J.G.G.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=O.T.%2BWiebenga%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wiebenga%20O&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AO.T.%2BWiebenga%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-6429-1973" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for O.T. Wiebenga</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">M.M. Schoonheim </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Anatomy and Neurosciences (O.T.W., M.M.S., H.E.H., G.J.A.N.<span class='nlm-sup'>†</span>, J.J.G.G.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.M.%2BSchoonheim%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Schoonheim%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.M.%2BSchoonheim%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-2504-6959" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.M. Schoonheim</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">H.E. Hulst </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Anatomy and Neurosciences (O.T.W., M.M.S., H.E.H., G.J.A.N.<span class='nlm-sup'>†</span>, J.J.G.G.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.E.%2BHulst%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hulst%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.E.%2BHulst%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-5039-1359" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H.E. Hulst</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">G.J.A. Nagtegaal </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology and Nuclear Medicine (O.T.W., G.J.A.N.<span class='nlm-sup'>†</span>, M.D.S., F.B.)</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Anatomy and Neurosciences (O.T.W., M.M.S., H.E.H., G.J.A.N.<span class='nlm-sup'>†</span>, J.J.G.G.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.J.A.%2BNagtegaal%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Nagtegaal%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AG.J.A.%2BNagtegaal%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">E.M.M. Strijbis </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Neurology (E.M.M.S., C.H.P.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=E.M.M.%2BStrijbis%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Strijbis%20E&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AE.M.M.%2BStrijbis%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-6705-5864" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for E.M.M. Strijbis</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">M.D. Steenwijk </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology and Nuclear Medicine (O.T.W., G.J.A.N.<span class='nlm-sup'>†</span>, M.D.S., F.B.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.D.%2BSteenwijk%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Steenwijk%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.D.%2BSteenwijk%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-8346-9044" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.D. Steenwijk</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">C.H. Polman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Neurology (E.M.M.S., C.H.P.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.H.%2BPolman%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Polman%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.H.%2BPolman%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-9253-1743" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C.H. Polman</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">P.J.W. Pouwels </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Physics and Medical Technology (P.J.W.P.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.J.W.%2BPouwels%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Pouwels%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.J.W.%2BPouwels%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-8430-0606" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.J.W. Pouwels</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">F. Barkhof </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology and Nuclear Medicine (O.T.W., G.J.A.N.<span class='nlm-sup'>†</span>, M.D.S., F.B.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.%2BBarkhof%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Barkhof%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AF.%2BBarkhof%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-3543-3706" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F. Barkhof</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">J.J.G. Geurts </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Anatomy and Neurosciences (O.T.W., M.M.S., H.E.H., G.J.A.N.<span class='nlm-sup'>†</span>, J.J.G.G.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.J.G.%2BGeurts%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Geurts%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.J.G.%2BGeurts%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-1896-3748" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.J.G. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-37.6.1030.1" data-doi="10.1016/S0140-6736(08)61620-7"><div class="cit-metadata"><ol class="cit-auth-list"><li>
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 37</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 6 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Jun 2016 </div></div>
      
      
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jun 2016, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1030-1037; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4690 </span></div>
  
  
  
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      <div class="highwire-cite-title">White Matter Diffusion Changes during the First Year of Natalizumab Treatment in Relapsing-Remitting Multiple Sclerosis</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">O.T.</span> <span class="nlm-surname">Wiebenga</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.M.</span> <span class="nlm-surname">Schoonheim</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">H.E.</span> <span class="nlm-surname">Hulst</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">G.J.A.</span> <span class="nlm-surname">Nagtegaal</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">E.M.M.</span> <span class="nlm-surname">Strijbis</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">M.D.</span> <span class="nlm-surname">Steenwijk</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">C.H.</span> <span class="nlm-surname">Polman</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">P.J.W.</span> <span class="nlm-surname">Pouwels</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Barkhof</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">J.J.G.</span> <span class="nlm-surname">Geurts</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jun 2016, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1030-1037; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4690 </span></div>
  
  
  
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