Mesaros S, Rocca M A, Absinta M, Ghezzi A, Milani N, Moiola L, Veggiotti P, Comi G, Filippi M
Neuroimaging Research Unit, Scientific Institute and University Hospital San Raffaele, Via Olgettina 60, 20132 Milan, Italy.
Neurology. 2008 Mar 25;70(13 Pt 2):1107-12. doi: 10.1212/01.wnl.0000291010.54692.85. Epub 2008 Feb 13.
We used voxel-based morphometry (VBM) to assess the pattern of regional gray matter (GM) loss in patients with pediatric multiple sclerosis (MS) and its relation with the Expanded Disability Status Scale (EDSS) score, disease duration, and the extent of T2 lesion load (LL).
From 28 patients with pediatric relapsing-remitting MS (16 girls; mean age = 14.4 years, range = 7 to 16 years) and 21 matched controls, dual-echo and three-dimensional T1-weighted magnetization prepared rapid acquisition gradient echo sequences were acquired. T2 LL was measured using a local thresholding segmentation technique. Data were analyzed using an optimized VBM analysis and statistical parametric mapping.
In pediatric patients with MS, mean brain T2 LL was 7.8 mL +/- 11.3. Intracranial volume did not differ between patients and controls. Compared to controls, patients with pediatric MS had significant GM loss in the thalamus, bilaterally, which was significantly correlated with T2 LL (r = -0.80 for the right thalamus, r = -0.74 for the left thalamus, p < 0.05, corrected for multiple comparisons). No correlation was found between thalamic GM loss, disease duration, and disability.
In patients with pediatric multiple sclerosis (MS), differently from what happens in adult-onset MS, gray matter (GM) atrophy seems to involve the thalamus only, with sparing of the cortex and other deep GM nuclei. The correlation found between atrophy and T2 lesion load suggests transsynaptic and Wallerian degenerations as the most likely substrate of tissue loss in the thalamus of these patients.
我们使用基于体素的形态学测量（VBM）来评估儿童多发性硬化症（MS）患者区域灰质（GM）丢失的模式及其与扩展残疾状态量表（EDSS）评分、病程和T2病变负荷（LL）范围的关系。
对28例儿童复发缓解型MS患者（16例女孩；平均年龄=14.4岁，范围=7至16岁）和21名匹配对照者，采集双回波和三维T1加权磁化准备快速采集梯度回波序列。使用局部阈值分割技术测量T2 LL。采用优化的VBM分析和统计参数映射对数据进行分析。
在儿童MS患者中，平均脑T2 LL为7.8 mL±11.3。患者和对照者的颅内体积无差异。与对照者相比，儿童MS患者双侧丘脑有显著的GM丢失，这与T2 LL显著相关（右侧丘脑r=-0.80，左侧丘脑r=-0.74，p<0.05，经多重比较校正）。未发现丘脑GM丢失与病程和残疾之间存在相关性。
在儿童多发性硬化症（MS）患者中，与成人发病的MS不同，灰质（GM）萎缩似乎仅累及丘脑，而皮质和其他深部GM核未受影响。萎缩与T2病变负荷之间的相关性表明，跨突触和华勒氏变性是这些患者丘脑组织丢失最可能的基础。
