Neuroimaging Research Unit, Institute of Experimental Neurology, Scientific Institute and University Ospedale San Raffaele, Via Olgettina, 60, 20132 Milan, Italy.
Eur J Neurosci. 2010 Apr;31(7):1273-80. doi: 10.1111/j.1460-9568.2010.07147.x. Epub 2010 Mar 19.
We combined functional magnetic resonance imaging (fMRI) and diffusion tensor tractography to investigate the functional and structural substrates of motor network dysfunction in patients with primary progressive multiple sclerosis (PPMS). In 15 right-handed PPMS patients and 15 age-matched healthy controls, we acquired diffusion tensor magnetic resonance imaging and fMRI during the performance of a simple motor task. Tractography was used to calculate diffusion tensor-derived measures of the corpus callosum, the corticospinal tract, the optic radiation, the fronto-occipital fasciculus, and the inferior longitudinal fasciculus. Analyses of fMRI activations and functional connectivity were performed using statistical parametric mapping (cluster threshold of P = 0.001, and extent cluster threshold of 10 voxels for comparison of activations; P < 0.05, family-wise error corrected for functional connectivity). As compared with controls, PPMS patients had more significant activations of the left postcentral gyrus, left secondary sensorimotor area, left parahippocampal gyrus, left cerebellum, right primary sensorimotor cortex (SMC), right basal ganglia, right insula, right cingulum, and cuneus bilaterally. As compared with PPMS patients, controls had increased functional connectivity between the left primary SMC and the ipsilateral inferior frontal gyrus. Conversely, PPMS patients showed increased functional connectivity between the left primary SMC and the right cuneus. Moderate correlations were found between functional activations and damage to the tracts studied (r-values between 0.82 and 0.84; P < 0.001). These results suggest that, as compared with healthy controls, PPMS patients show increased activations and abnormal functional connectivity measures in several areas of the sensorimotor network. Such changes are correlated with the structural damage to the white matter fiber bundles connecting these regions.
我们结合功能磁共振成像（fMRI）和弥散张量纤维束成像来研究原发性进展型多发性硬化症（PPMS）患者运动网络功能障碍的功能和结构基础。在 15 名右利手 PPMS 患者和 15 名年龄匹配的健康对照者中，我们在执行简单运动任务期间采集了弥散张量磁共振成像和 fMRI。利用纤维束追踪技术计算了胼胝体、皮质脊髓束、视辐射、额枕束和下额枕束的弥散张量衍生测量值。使用统计参数映射（激活比较的 P = 0.001，激活簇阈值；功能连接比较的 P < 0.05，校正了功能连接的组间错误）对 fMRI 激活和功能连接进行分析。与对照组相比，PPMS 患者的左侧中央后回、左侧次级感觉运动区、左侧海马旁回、左侧小脑、右侧初级感觉运动皮层（SMC）、右侧基底节、右侧岛叶、右侧扣带回和双侧楔叶的激活更为显著。与 PPMS 患者相比，对照组的左侧初级 SMC 与同侧额下回之间的功能连接增加。相反，PPMS 患者的左侧初级 SMC 与右侧楔叶之间的功能连接增加。功能激活与研究的束损伤之间存在中度相关性（r 值在 0.82 到 0.84 之间；P < 0.001）。这些结果表明，与健康对照组相比，PPMS 患者的感觉运动网络多个区域的激活增加和功能连接测量异常。这些变化与连接这些区域的白质纤维束的结构损伤有关。
