Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Scientific Institute and University Ospedale San Raffaele, Milan, Italy.
Neurology. 2010 Apr 20;74(16):1252-9. doi: 10.1212/WNL.0b013e3181d9ed91.
This study explores default-mode network (DMN) abnormalities in patients with secondary progressive (SP) and primary progressive (PP) multiple sclerosis (MS) and whether such abnormalities correlate with cognitive impairment and damage to selected white matter (WM) fiber bundles, quantified using diffusion tensor (DT) MRI tractography.
Resting state (RS) functional MRI and DT MRI data were acquired from 33 patients with SPMS, 24 patients with PPMS, and 24 controls. Independent component analysis (ICA) was used to identify the DMN. SPM5 was used to assess within- and between-group activations.
Between-group differences in DMN activity were found in the left medial prefrontal cortex (mPFC), left precentral gyrus (PcG), and anterior cingulate cortex (ACC). Compared to controls, patients with SPMS had reduced activity in the mPFC (p = 0.01) and PcG (p = 0.02), while patients with PPMS had reduced activity in the PcG (p = 0.008) and the ACC (p = 0.002). Compared to patients with PPMS, patients with SPMS had increased ACC activity (p = 0.04). Reduction of RS activity in the ACC was more pronounced in cognitively impaired vs cognitively preserved patients with MS (p = 0.02). In patients with MS, DMN abnormalities correlated with the PASAT and word list test scores (r values ranging from 0.35 to 0.45) and DT MRI changes in the corpus callosum and the cingulum (r values ranging from 0.82 to 0.87).
These results suggest that a dysfunction of the anterior components of the default-mode network may be among the factors responsible for the accumulation of cognitive deficits in patients with progressive multiple sclerosis.
本研究旨在探索继发进展型（SP）和原发进展型（PP）多发性硬化症（MS）患者默认模式网络（DMN）的异常，并研究这些异常是否与认知障碍以及使用弥散张量（DT）MRI 纤维束追踪技术定量评估的特定白质（WM）纤维束损伤有关。
从 33 例 SPMS 患者、24 例 PPMS 患者和 24 例对照中采集静息态（RS）功能 MRI 和 DT MRI 数据。使用独立成分分析（ICA）识别 DMN。使用 SPM5 评估组内和组间激活。
在左侧内侧前额叶皮质（mPFC）、左侧中央前回（PcG）和前扣带皮层（ACC）发现了 DMN 活性的组间差异。与对照组相比，SPMS 患者的 mPFC（p = 0.01）和 PcG（p = 0.02）的活性降低，而 PPMS 患者的 PcG（p = 0.008）和 ACC（p = 0.002）的活性降低。与 PPMS 患者相比，SPMS 患者的 ACC 活性增加（p = 0.04）。MS 患者中，RS 活性在认知障碍与认知正常患者的 ACC 中差异显著（p = 0.02）。MS 患者的 DMN 异常与 PASAT 和单词列表测试评分（r 值范围为 0.35 至 0.45）以及胼胝体和扣带束的 DT MRI 变化（r 值范围为 0.82 至 0.87）相关。
这些结果表明，默认模式网络前区功能障碍可能是导致进展性多发性硬化症患者认知缺陷累积的因素之一。
