Ceccarelli Antonia, Rocca Maria A, Pagani Elisabetta, Colombo Bruno, Martinelli Vittorio, Comi Giancarlo, Filippi Massimo
Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy.
Neuroimage. 2008 Aug 1;42(1):315-22. doi: 10.1016/j.neuroimage.2008.04.173. Epub 2008 Apr 20.
To assess regional grey matter (GM) changes in a large cohort of multiple sclerosis (MS) patients with different clinical phenotypes, using voxel-based morphometry (VBM) and their correlation with the extent of global and regional T2 lesion volumes (LV), we acquired conventional MRI scans from 71 MS patients with different clinical phenotypes (26 with relapsing-remitting [RR] MS, 27 with secondary progressive [SP] MS and 18 with primary progressive [PP] MS), 28 patients with a clinically isolated syndrome (CIS) suggestive of MS, and 21 controls. No GM loss was found in CIS patients. Compared to CIS patients, those with RRMS had a significant GM loss in the right pre and postcentral gyri. Compared to RRMS, SPMS patients had a significant GM loss in several regions of the fronto-parieto-temporo-occipital lobes, the cerebellum and superior and inferior colliculus, bilaterally, and deep GM structures. Compared to PPMS, SPMS patients had a significant GM loss in the postcentral gyrus, the cuneus, the middle occipital gyrus, the thalamus, the cerebellum, and the superior and inferior colliculus. In all MS groups, regional GM loss was strongly/moderately correlated with brain T2 LV. In SPMS and PPMS patients, a correlation was found between cortical regional GM loss and T2 LV of the corresponding or adjacent lobes. In MS patients, GM volume loss follows different patterns of regional distribution according to the clinical phenotype of the disease, is likely secondary to the presence and topography of focal WM inflammatory-demyelinating lesions, and is more evident in the progressive forms of the disease.
为了使用基于体素的形态学测量（VBM）方法评估一大群具有不同临床表型的多发性硬化症（MS）患者的区域灰质（GM）变化及其与整体和区域T2病变体积（LV）范围的相关性，我们对71例具有不同临床表型的MS患者（26例复发缓解型[RR]MS、27例继发进展型[SP]MS和18例原发进展型[PP]MS）、28例提示MS的临床孤立综合征（CIS）患者以及21名对照者进行了常规MRI扫描。在CIS患者中未发现GM丢失。与CIS患者相比，RRMS患者在右侧中央前回和中央后回有显著的GM丢失。与RRMS相比，SPMS患者在双侧额顶颞枕叶、小脑、上丘和下丘以及深部GM结构的多个区域有显著的GM丢失。与PPMS相比，SPMS患者在中央后回、楔叶、枕中回、丘脑、小脑以及上丘和下丘有显著的GM丢失。在所有MS组中，区域GM丢失与脑T2 LV强烈/中度相关。在SPMS和PPMS患者中，发现皮质区域GM丢失与相应或相邻叶的T2 LV之间存在相关性。在MS患者中，GM体积丢失根据疾病的临床表型遵循不同的区域分布模式，可能继发于局灶性白质炎性脱髓鞘病变的存在和位置，并且在疾病的进展形式中更为明显。
