Objective: The aim was to determine whether the presence of anti-Epstein Barr virus (EBV) antibodies is associated with magnetic resonance imaging (MRI) measures of brain injury and neurodegeneration in multiple sclerosis (MS) patients.
Methods: A total of 135 MS patients (86 females; 49 males) underwent brain MRI and testing for antibodies against EBV. The MRI measurements included gadolinium-enhancing (Gd) lesion volume, T1- and T2- lesion volumes and fractions of whole brain parenchyma (BPF), white matter (WMF) and gray matter (GMF). The anti-EBV panel included anti-EBV early antigen (EA) IgG, anti-EBV nuclear antigen (EBNA) IgG and anti-EBV viral capsid antigen (VCA) IgG levels. The relationships between antibody levels and MRI measurements were assessed in regression analysis. Repeated measurements of anti-EBV VCA IgG and MRI measures were available for a subset of 50 patients after mean follow-up of 3.1 years.
Results: The GMF (R2 = 0.24 for overall model and Standardized β = -0.26, p = 0.002) and BPF (R2 = 0.39 for overall model and Standardized β = -0.28, p < 0.001) showed negative associations with anti-EBV-VCA IgG levels. Higher decline in BPF was significantly associated with increased -3-year time point anti-EBV VCA IgG levels (p = 0.007).
Conclusions: The results suggest that the presence of anti-EBV antibodies is associated with MRI markers of GM atrophy in MS and with increased loss of brain volume over 3-year follow-up.