Bakshi Rohit, Dandamudi Venkata S R, Neema Mohit, De Chitradeep, Bermel Robert A
Center for Neurological Imaging, Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
J Neuroimaging. 2005;15(4 Suppl):30S-45S. doi: 10.1177/1051228405283901.
Evaluation of brain and spinal cord atrophy by magnetic resonance imaging (MRI) has become an increasingly important component of understanding the multiple sclerosis (MS) disease process. These destructive aspects of the disease develop early in the disease course. A growing body of data links brain and spinal cord atrophy to clinical impairment more closely than can be linked with conventional measures of overt lesions. Thus, irreversible tissue damage may be a key factor leading to disease progression. In this review, the authors present the proposed mechanisms leading to central nervous system (CNS) atrophy. They describe the available MRI-based techniques to measure regional and global atrophy of the brain and spinal cord. They compare the rate of atrophy among MS phenotypes and summarize the emerging data linking atrophy to neurological and neuropsychological impairment. Finally, they discuss the effect of disease-modifying immunotherapies on the rate of CNS atrophy in patients with MS. Future research to clarify the etiology and pathophysiology of brain and spinal cord atrophy should provide new targets for therapeutic development.
通过磁共振成像（MRI）评估脑和脊髓萎缩已成为理解多发性硬化症（MS）疾病进程中越来越重要的组成部分。疾病的这些破坏性方面在病程早期就会出现。越来越多的数据表明，脑和脊髓萎缩与临床损伤的关联比与明显病变的传统测量方法的关联更为紧密。因此，不可逆的组织损伤可能是导致疾病进展的关键因素。在这篇综述中，作者提出了导致中枢神经系统（CNS）萎缩的机制。他们描述了基于MRI的现有技术，用于测量脑和脊髓的局部和整体萎缩。他们比较了MS各表型之间的萎缩率，并总结了将萎缩与神经和神经心理损伤联系起来的新出现的数据。最后，他们讨论了疾病修饰免疫疗法对MS患者CNS萎缩率的影响。未来旨在阐明脑和脊髓萎缩的病因和病理生理学的研究应能为治疗开发提供新的靶点。
