Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, and Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, Milan 20132, Italy.
Radiology. 2012 Dec;265(3):864-73. doi: 10.1148/radiol.12120216. Epub 2012 Sep 10.
To determine whether modification of the connections between cerebellar and prefrontal areas might vary among multiple sclerosis (MS) phenotypes and might be associated with cognitive failure.
Approval of the institutional review boards and written informed consent were obtained from each participant. Stroop-related functional magnetic resonance (MR) imaging activations and effective connectivity abnormalities between the right cerebellum and any other brain regions were assessed by using a psychophysiologic interaction (PPI) analysis from 17 patients with relapsing-remitting (RR), 17 with benign, and 23 with secondary progressive (SP) MS and 18 healthy control subjects (P < .05, corrected at cluster level). Correlations with disease duration, T2 lesion volume, brain volume, and response times (RTs) during the incongruent condition were estimated (P < .001, uncorrected).
Activation and PPI analyses showed that, compared with the other groups, RR MS group had abnormal recruitment of regions of the left frontoparietal lobes, whereas compared with RR MS group, SP MS group had abnormal recruitment of the cingulum or precuneus. Benign MS group had increased activation of the right prefrontal cortex, and increased interaction between these regions and the right cerebellum. In healthy controls, RTs inversely correlated with activity of right cerebellum and several frontoparietal regions. In MS, RTs inversely correlated with bilateral cerebellar activity and directly correlated with right precuneus activity. In MS, disease duration inversely correlated with right cerebellar activity and directly correlated with left inferior frontal gyrus and right precuneus activity. Higher T2 lesion volume and lower brain volumes were related to activity in these areas.
Patients with MS who have various clinical phenotypes experience different abnormalities in activation and effective connectivity between the right cerebellum and frontoparietal areas, which contribute to inefficient cortical reorganization, with increasing cognitive load.
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120216/-/DC1.
确定小脑与前额叶区域之间连接的改变是否在多发性硬化症 (MS) 多种表型中存在差异，并且是否与认知失败相关。
每位参与者均获得了机构审查委员会的批准和书面知情同意。通过使用心理生理交互 (PPI) 分析，评估了 17 例复发缓解型 (RR)、17 例良性和 23 例继发进展型 (SP) MS 患者以及 18 例健康对照者的与 Stroop 相关的功能磁共振 (MR) 成像激活以及右侧小脑与任何其他脑区之间的有效连接异常（P <.05，在簇水平上进行校正）。估计了与疾病持续时间、T2 病变体积、脑体积和不一致条件下的反应时间 (RT) 的相关性（P <.001，未校正）。
激活和 PPI 分析表明，与其他组相比，RR MS 组左额顶叶区域的募集异常，而与 RR MS 组相比，SP MS 组扣带回或楔前叶的募集异常。良性 MS 组右前额叶皮质的激活增加，并且这些区域与右侧小脑之间的相互作用增加。在健康对照组中，RT 与右侧小脑和几个额顶叶区域的活动呈负相关。在 MS 中，RT 与双侧小脑活动呈负相关，与右侧楔前叶活动呈正相关。在 MS 中，疾病持续时间与右侧小脑活动呈负相关，与左侧额下回和右侧楔前叶活动呈正相关。较高的 T2 病变体积和较低的脑体积与这些区域的活动有关。
具有不同临床表型的 MS 患者在右侧小脑与额顶区域之间的激活和有效连接方面经历不同的异常，这导致在认知负荷增加时皮质重组效率降低。
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120216/-/DC1.
