Wybrecht Delphine, Reuter Françoise, Zaaraoui Wafaa, Faivre Anthony, Crespy Lydie, Rico Audrey, Malikova Irina, Confort-Gouny Sylviane, Soulier Elisabeth, Cozzone Patrick J, Pelletier Jean, Ranjeva Jean-Philippe, Audoin Bertrand
Aix-Marseille University, CEMEREM, UMR 7339, Marseille, France.
Mult Scler. 2012 Nov;18(11):1585-91. doi: 10.1177/1352458512442991. Epub 2012 Mar 27.
The ability of conventional magnetic resonance imaging (MRI) to predict subsequent physical disability and cognitive deterioration after a clinically isolated syndrome (CIS) is weak.
We aimed to investigate whether conventional MRI changes over 1 year could predict cognitive and physical disability 5 years later in CIS. We performed analyses using a global approach (T(2) lesion load, number of T(2) lesions), but also a topographic approach.
This study included 38 patients with a CIS. At inclusion, 10 out of 38 patients fulfilled the 2010 revised McDonald's criteria for the diagnosis of multiple sclerosis. Expanded Disability Status Scale (EDSS) evaluation was performed at baseline, year 1 and year 5, and cognitive evaluation at baseline and year 5. T(2)-weighted MRI was performed at baseline and year 1. We used voxelwise analysis to analyse the predictive value of lesions location for subsequent disability.
Using the global approach, no correlation was found between MRI and clinical data. The occurrence or growth of new lesions in the brainstem was correlated with EDSS changes over the 5 years of follow-up. The occurrence or growth of new lesions in cerebellum, thalami, corpus callosum and frontal lobes over 1 year was correlated with cognitive impairment at 5 years.
The assessment of lesion location at the first stage of multiple sclerosis may be of value to predict future clinical disability.
传统磁共振成像（MRI）预测临床孤立综合征（CIS）后后续身体残疾和认知衰退的能力较弱。
我们旨在研究CIS患者1年内传统MRI变化是否能预测5年后的认知和身体残疾。我们采用整体方法（T2病变负荷、T2病变数量）以及局部方法进行分析。
本研究纳入38例CIS患者。纳入时，38例患者中有10例符合2010年修订的麦克唐纳多发性硬化诊断标准。在基线、第1年和第5年进行扩展残疾状态量表（EDSS）评估，在基线和第5年进行认知评估。在基线和第1年进行T2加权MRI检查。我们采用体素分析来分析病变位置对后续残疾的预测价值。
采用整体方法时，未发现MRI与临床数据之间存在相关性。脑干中新发病变的出现或增长与随访5年期间的EDSS变化相关。1年内小脑、丘脑、胼胝体和额叶中新发病变的出现或增长与5年后的认知障碍相关。
在多发性硬化症的第一阶段评估病变位置可能对预测未来临床残疾具有价值。
