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ORIGINAL RESEARCH article

Front. Neurol.

Sec. Multiple Sclerosis and Neuroimmunology

Multimodal MRI Assessment of Neuroprotective Effects of Ofatumumab on Brain Structure, Function, and Clinical Correlates in Relapsing Multiple Sclerosis

Provisionally accepted
Xiaoshuang WangXiaoshuang Wang1Jing AnJing An2Zhaoshi ZhengZhaoshi Zheng2Yingyu ZhangYingyu Zhang2Di WangDi Wang2Yaxin QuYaxin Qu2Qiurong YangQiurong Yang2Shuai WangShuai Wang2Xuemei HanXuemei Han2*
  • 1China-Japan Union Hospital, Jilin University, Changchun, China
  • 2China-Japan Union Hospital of Jilin University, Changchun, China

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Relapsing Multiple Sclerosis (RMS) is characterized by neuroinflammation and neurodegeneration, leading to disability. Ofatumumab (OFA), an anti-CD20 monoclonal antibody, has shown promise as a disease-modifying therapy. This study aimed to assess the neuroprotective effects of OFA in RMS using multimodal magnetic resonance imaging (MRI). We conducted a retrospective cohort study comparing 16 RMS patients receiving OFA for one year (Treatment Group, TG) with 8 treatment-naïve patients (No-Treatment Group, NTG). Participants underwent 3T MRI scans, including 3D T1-weighted, diffusion tensor imaging (DTI), and resting-state functional MRI (rs-fMRI). Clinical outcomes were measured using the Expanded Disability Status Scale (EDSS), Timed 25-Foot Walk (T25FW), and cognitive assessments. Results showed significant improvements in motor function and anxiety in the TG, alongside increased white matter integrity and stable cognition. Notably, TG patients exhibited enhanced functional connectivity between the thalamus and cortex, as well as increased fractional anisotropy (FA) in key white matter tracts. In contrast, the NTG displayed gray matter atrophy. These preliminary findings suggest that OFA treatment may preserve brain structure and function in RMS, with potential neuroprotective effects mediated, through thalamocortical network modulation and white matter restoration.

Keywords: Disease modifying therapy, functional connectivity, Multiple Sclerosis, Neuroimaging, Ofatumumab

Received: 09 Nov 2025; Accepted: 13 Jan 2026.

Copyright: © 2026 Wang, An, Zheng, Zhang, Wang, Qu, Yang, Wang and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Xuemei Han

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material