Leocani L, Locatelli T, Martinelli V, Rovaris M, Falautano M, Filippi M, Magnani G, Comi G
Department of Clinical Neurophysiology, Scientific Institute H San Raffaele, Via Olgettina 60, 20132 Milan, Italy.
J Neurol Neurosurg Psychiatry. 2000 Aug;69(2):192-8. doi: 10.1136/jnnp.69.2.192.
To explore functional corticocortical connections in multiple sclerosis by means of coherence of the EEG, and to evaluate their correlations with the degree of cognitive impairment and with brain lesion load assessed by MRI.
EEG coherence was studied from 28 patients with clinically definite multiple sclerosis. Ten minutes of resting EEG were recorded with 20 scalp electrodes, with binaural reference. FFT power and coherence were calculated in artifact free epochs of 1 second and compared with values from 22 control subjects of comparable age and sex distribution. Patients also underwent MRI (n=27) and neuropsychological examination (n=21).
Compared with controls, patients with multiple sclerosis showed increased theta power in the frontotemporal-central regions (p<0.005). theta Band coherence was decreased between homologous areas (p<0.02). alpha Band coherence was decreased both in the local and long distance connections (p<0.0005). These findings were most striking both in patients with high MRI subcortical lesion load and in patients with cognitive involvement. A significant correlation was found between interhemispheric theta (p=0.02) and alpha (p=0. 017) and anteroposterior alpha (p=0.013) coherence and subcortical MRI lesion load, but not with exclusively periventricular lesion load.
These findings support the hypothesis that cognitive impairment in multiple sclerosis is mostly dependent on involvement of corticocortical connections related to demyelination and/or axonal loss within the white matter immediately underlying the cortex.
通过脑电图的相干性探索多发性硬化症中皮质与皮质之间的功能连接,并评估它们与认知障碍程度以及磁共振成像评估的脑病变负荷之间的相关性。
对28例临床确诊的多发性硬化症患者进行脑电图相干性研究。使用20个头皮电极记录10分钟静息脑电图,采用双耳参考。在无伪迹的1秒时段内计算快速傅里叶变换(FFT)功率和相干性,并与年龄和性别分布相当的22名对照受试者的值进行比较。患者还接受了磁共振成像检查(n = 27)和神经心理学检查(n = 21)。
与对照组相比,多发性硬化症患者在额颞叶 - 中央区域的θ波功率增加(p < 0.005)。同源区域之间的θ频段相干性降低(p < 0.02)。α频段相干性在局部和远距离连接中均降低(p < 0.0005)。这些发现在磁共振成像显示皮质下病变负荷高的患者和有认知受累的患者中最为明显。半球间θ波(p = 0.02)和α波(p = 0.017)以及前后α波(p = 0.013)的相干性与皮质下磁共振成像病变负荷之间存在显著相关性,但与仅脑室周围病变负荷无关。
这些发现支持以下假设,即多发性硬化症中的认知障碍主要取决于与皮质下紧邻白质内脱髓鞘和/或轴突丢失相关的皮质与皮质之间连接的受累情况。