Benedict R H B, Ramasamy D, Munschauer F, Weinstock-Guttman B, Zivadinov R
Jacobs Neurological Institute, Buffalo Neuroimaging Analysis Center, and Department of Neurology, State University of New York at Buffalo, New York 14203, USA.
J Neurol Neurosurg Psychiatry. 2009 Feb;80(2):201-6. doi: 10.1136/jnnp.2008.148403. Epub 2008 Oct 1.
MRI research in multiple sclerosis (MS) samples reveals pathology in both the cerebral cortex and deep grey matter (DGM). The classical subcortical dementia hypothesis has been ascribed to MS and is supported by studies highlighting the role of thalamic atrophy in neuropsychological outcomes. However, the importance of mesial temporal lobe (MTL) atrophy in MS is largely untested and poorly understood. New structural imaging techniques permit volumetric measures of multiple regions within the MTL lobe and DGM.
To determine the relative importance of MTL and DGM structures in predicting MS performance on memory tests presented in the auditory/verbal and visual/spatial spheres.
Cross sectional analysis of 50 patients with MS undergoing structural brain MRI and neuropsychological testing. Using Freesurfer software, the volumes of the MTL (hippocampus, amygdala) and DGM (thalamus, caudate) structures were calculated and compared with control values. Neuropsychological testing contributed measures of new learning, delayed recall and recognition memory, in the auditory/verbal and visual/spatial memory modalities.
Significant correlations between lower regional volume and poorer test performance were observed across all memory tests. For measures of free recall or new learning, DGM volumes were most strongly predictive of outcomes. In contrast, measures of recognition memory were predicted only by MTL volumetric measures.
For the first time, the predictive validity of MTL and DGM atrophy were simultaneously compared with MS using reliable and validated neuropsychological measures. This study found that both compartments play significant but different roles in the amnesia of MS.
对多发性硬化症（MS）样本的MRI研究揭示了大脑皮层和深部灰质（DGM）的病变。经典的皮质下痴呆假说已被归因于MS，并且有研究强调丘脑萎缩在神经心理学结果中的作用，这为该假说提供了支持。然而，内侧颞叶（MTL）萎缩在MS中的重要性在很大程度上尚未得到检验，人们对此了解也很少。新的结构成像技术允许对MTL叶和DGM内的多个区域进行体积测量。
确定MTL和DGM结构在预测MS患者在听觉/语言和视觉/空间领域的记忆测试表现方面的相对重要性。
对50例接受脑部结构MRI和神经心理学测试的MS患者进行横断面分析。使用Freesurfer软件计算MTL（海马体、杏仁核）和DGM（丘脑、尾状核）结构的体积，并与对照值进行比较。神经心理学测试提供了听觉/语言和视觉/空间记忆模式下新学习、延迟回忆和识别记忆的测量值。
在所有记忆测试中，均观察到较低的区域体积与较差的测试表现之间存在显著相关性。对于自由回忆或新学习的测量，DGM体积对结果的预测性最强。相比之下，识别记忆的测量仅由MTL体积测量值预测。
首次使用可靠且经过验证的神经心理学测量方法，同时比较了MTL和DGM萎缩对MS的预测效度。本研究发现，这两个区域在MS失忆中都起着重要但不同的作用。
