Dogonowski A-M, Siebner H R, Soelberg Sørensen P, Paulson O B, Dyrby T B, Blinkenberg M, Madsen K H
Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
Acta Neurol Scand. 2013 Nov;128(5):328-35. doi: 10.1111/ane.12121. Epub 2013 Mar 6.
To characterize the relationship between motor resting-state connectivity of the dorsal pre-motor cortex (PMd) and clinical disability in patients with multiple sclerosis (MS).
A total of 27 patients with relapsing-remitting MS (RR-MS) and 15 patients with secondary progressive MS (SP-MS) underwent functional resting-state magnetic resonance imaging. Clinical disability was assessed using the Expanded Disability Status Scale (EDSS). Independent component analysis was used to characterize motor resting-state connectivity. Multiple regression analysis was performed in SPM8 between the individual expression of motor resting-state connectivity in PMd and EDSS scores including age as covariate. Separate post hoc analyses were performed for patients with RR-MS and SP-MS.
The EDSS scores ranged from 0 to 7 with a median score of 4.3. Motor resting-state connectivity of left PMd showed a positive linear relation with clinical disability in patients with MS. This effect was stronger when considering the group of patients with RR-MS alone, whereas patients with SP-MS showed no increase in coupling strength between left PMd and the motor resting-state network with increasing clinical disability. No significant relation between motor resting-state connectivity of the right PMd and clinical disability was detected in MS.
The increase in functional coupling between left PMd and the motor resting-state network with increasing clinical disability can be interpreted as adaptive reorganization of the motor system to maintain motor function, which appears to be limited to the relapsing-remitting stage of the disease.
明确多发性硬化症（MS）患者背侧运动前皮质（PMd）的静息态运动连接性与临床残疾之间的关系。
共27例复发缓解型MS（RR-MS）患者和15例继发进展型MS（SP-MS）患者接受了静息态功能磁共振成像检查。使用扩展残疾状态量表（EDSS）评估临床残疾情况。采用独立成分分析来表征静息态运动连接性。在SPM8中进行多元回归分析，以PMd静息态运动连接性的个体表达与EDSS评分作为因变量，年龄作为协变量。对RR-MS患者和SP-MS患者分别进行事后分析。
EDSS评分范围为0至7，中位数为4.3。MS患者中，左侧PMd的静息态运动连接性与临床残疾呈正线性关系。单独考虑RR-MS患者组时，这种效应更强，而SP-MS患者中，随着临床残疾程度增加，左侧PMd与静息态运动网络之间的耦合强度并未增加。在MS患者中，未检测到右侧PMd的静息态运动连接性与临床残疾之间存在显著关系。
随着临床残疾程度增加，左侧PMd与静息态运动网络之间功能耦合的增加可被解释为运动系统为维持运动功能而进行的适应性重组，这种重组似乎仅限于疾病的复发缓解阶段。
