University Hospital Basel, Switzerland.
Mult Scler. 2014 Feb;20(2):202-13. doi: 10.1177/1352458513493034. Epub 2013 Jun 26.
In multiple sclerosis (MS) regional grey matter (GM) atrophy has been associated with disability progression.
The aim of this study was to compare regional GM volume changes in relapsing-remitting MS (RRMS) patients with progressive and stable disability, using voxel-based morphometry (VBM).
We acquired baseline and 1-year follow-up 3-dimensional (3D) T1-weighted magnetic resonance imaging (MRI) data of RRMS patients, using two 1.5-Tesla scanners. Patients were matched pair-wise with respect to age, gender, disease duration, medication, scanner and baseline Expanded Disability Status Scale (EDSS) into 13 pairs, with either progressive EDSS (≥ 1 point change y(-1)) or stable EDSS, as well as into 29 pairs with either progressive Multiple Sclerosis Functional Composite (MSFC) at ≥ 0.25% decrease in y(-1) in any component, or stable MSFC. We analysed longitudinal regional differences in GM volumes in the progressive and stable EDSS and MSFC groups, respectively, using VBM.
Significant GM volume reductions occurred in the right precuneus, in the progressive EDSS group. Differential between-group effects occurred in the right precuneus and in the postcentral gyrus. Further longitudinal GM volume reductions occurred in the right orbicular gyrus, in the progressive MSFC group, but no between-group differences were observed (non-stationary cluster-wise inference, all P(corrected) < 0.05).
These results suggested a direct association of disability progression and regional GM atrophy in RRMS.
在多发性硬化症(MS)中,区域性灰质(GM)萎缩与残疾进展有关。
本研究旨在使用基于体素的形态测量学(VBM)比较复发缓解型多发性硬化症(RRMS)患者中具有进行性和稳定残疾的患者的区域性 GM 体积变化。
我们使用两台 1.5T 磁共振扫描仪获取 RRMS 患者的基线和 1 年随访的 3 维(3D)T1 加权磁共振成像(MRI)数据。根据年龄、性别、疾病持续时间、药物、扫描仪和基线扩展残疾状况量表(EDSS),将患者与进展性 EDSS(≥1 点/y 的变化)或稳定 EDSS、以及进行性多发性 sclerosis 功能复合(MSFC)≥0.25%/y 的任何成分下降或稳定 MSFC 的患者进行配对。我们使用 VBM 分析了进展性 EDSS 和 MSFC 组中 GM 体积的纵向区域差异。
在进展性 EDSS 组中,右侧楔前叶出现了显著的 GM 体积减少。在右楔前叶和后中央回出现了组间差异。在进展性 MSFC 组中,右侧眶回出现了进一步的纵向 GM 体积减少,但未观察到组间差异(非静止聚类推断,所有 P(corrected)<0.05)。
这些结果表明 RRMS 中残疾进展与区域性 GM 萎缩之间存在直接关联。