Ceccarelli Antonia, Rocca Maria A, Pagani Elisabetta, Ghezzi Angelo, Capra Ruggero, Falini Andrea, Scotti Giuseppe, Comi Giancarlo, Filippi Massimo
Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy.
Neuroimage. 2008 Feb 15;39(4):1499-509. doi: 10.1016/j.neuroimage.2007.11.002. Epub 2007 Nov 13.
We compared the global and regional distribution of white matter (WM) and gray matter (GM) damage and T2-visible lesion between patients with benign (B) and relapsing remitting (RR) multiple sclerosis (MS). BMS and RRMS patients did not differ in terms of global volumes and diffusion tensor (DT) MRI metrics of the WM and GM. Compared to controls, BMS and RRMS patients had bilateral thalamic loss. Compared to controls, BMS and RRMS patients had lower WM fractional anisotropy (FA) in the corpus callosum (CC) and in several regions of temporal and occipital lobes. BMS also had a decreased WM FA in the parietal lobes. RRMS patients had also lower WM FA in several regions of the frontal lobes. Compared to BMS, RRMS patients had decreased WM FA in the frontal lobes, while the opposite comparison showed lower WM FA in the CC, the temporal lobes and the cuneus in BMS. Contrasted to controls, both MS groups showed several regions of increased MD in WM and GM, but no difference was found between MS sub-groups. T2-visible lesions were mainly located in the posterior regions of the brain in BMS patients, while they involved also regions in the frontal lobes, in RRMS patients. BMS and RRMS patients differ in terms of the topographical distribution of WM damage rather than in the overall extent of brain structural changes. The less prominent involvement of the frontal lobe WM and of the NAWM in general in BMS might be associated to their favorable clinical status.
我们比较了良性（B）型和复发缓解（RR）型多发性硬化（MS）患者之间白质（WM）和灰质（GM）损伤以及T2可见病变的整体和区域分布。BMS患者和RRMS患者在WM和GM的总体积以及扩散张量（DT）MRI指标方面没有差异。与对照组相比，BMS患者和RRMS患者双侧丘脑有损伤。与对照组相比，BMS患者和RRMS患者胼胝体（CC）以及颞叶和枕叶的几个区域的WM分数各向异性（FA）较低。BMS患者顶叶的WM FA也降低。RRMS患者额叶的几个区域的WM FA也较低。与BMS患者相比，RRMS患者额叶的WM FA降低，而相反的比较显示BMS患者CC、颞叶和楔叶的WM FA较低。与对照组相比，两个MS组的WM和GM中均有几个区域的平均扩散率（MD）增加，但MS亚组之间未发现差异。BMS患者的T2可见病变主要位于脑后部区域，而RRMS患者的病变还累及额叶区域。BMS患者和RRMS患者在WM损伤的地形分布方面存在差异，而不是在脑结构变化的总体程度上。BMS患者额叶WM和正常 appearing 白质（NAWM）总体受累不太明显可能与其良好的临床状态有关。
