The Jacobs Neurological Institute, Baird Multiple Sclerosis Center, Department of Neurology, State University of New York, E2 Buffalo General Hospital, Buffalo, NY 14203, USA.
Neurology. 2010 Feb 16;74(7):538-44. doi: 10.1212/WNL.0b013e3181cff6fb. Epub 2010 Jan 20.
African American (AA) patients with multiple sclerosis (MS) have more rapid disease progression and poorer responses to disease-modifying therapies than white American (WA) patients with MS.
To investigate brain MRI characteristics in AA compared to WA in a cohort of consecutive patients with MS.
We studied 567 patients with MS (age: 45.1 +/- SD 9.8 years, disease duration: 13.4 +/- 8.6 years), comprised of 488 WA and 79 AA. All patients obtained clinical and quantitative MRI evaluation. The majority of patients, 96% of AA and 94% of WA, were on disease-modifying therapies. The MRI measures included T1-, T2-, and gadolinium contrast-enhancing (CE) lesion volumes (LV) and CE number, global and tissue-specific brain atrophy, and magnetization transfer ratio (MTR) in lesions and normal-appearing gray matter (NAGM) and white matter (NAWM). The associations between race and clinical and MRI measurements were assessed in regression analysis.
The MTR values in lesions and in NAGM and NAWM were significantly lower in AA compared to WA. The AA group had 31% greater T2-LV and 101% greater T1-LV compared to WA. The MS Severity Score for AA (mean +/- SD = 4.3 +/- 2.9) was greater than for WA (3.8 +/- 2.5), despite a shorter disease duration in AA, indicating more aggressive clinical disease.
African American patients showed increased tissue damage, as measured by magnetization transfer ratio, and presented higher lesion volumes compared to white Americans. The greater tissue damage and faster lesion volume accumulation may explain the rapid clinical progression in African American patients.
非裔美国（AA）多发性硬化症（MS）患者的疾病进展速度比白种美国（WA）患者更快，对疾病修正治疗的反应也更差。
在连续 MS 患者队列中，比较 AA 与 WA 的脑 MRI 特征。
我们研究了 567 名 MS 患者（年龄：45.1 +/- 9.8 岁，病程：13.4 +/- 8.6 年），其中 488 名为 WA，79 名为 AA。所有患者均接受临床和定量 MRI 评估。大多数患者（96%的 AA 和 94%的 WA）接受了疾病修正治疗。MRI 测量包括 T1-、T2-和钆增强（CE）病变体积（LV）和 CE 数量、整体和组织特异性脑萎缩以及病变和正常外观灰质（NAGM）和白质（NAWM）中的磁化转移率（MTR）。在回归分析中评估了种族与临床和 MRI 测量之间的关系。
与 WA 相比，AA 的病变和 NAGM 及 NAWM 的 MTR 值明显更低。AA 组的 T2-LV 比 WA 组大 31%，T1-LV 比 WA 组大 101%。AA 的 MS 严重程度评分（均值 +/- 标准差=4.3 +/- 2.9）高于 WA（3.8 +/- 2.5），尽管 AA 的病程较短，但表明更具侵袭性的临床疾病。
与白种美国人相比，非裔美国患者的组织损伤程度更大，磁化转移率更高，病变体积更大。更大的组织损伤和更快的病变体积积累可能解释了非裔美国患者的快速临床进展。
