一项扩散张量磁共振成像研究表明，多发性硬化症患者的皮质下深部灰质病变与白质病变负荷及萎缩有关，但与皮质萎缩无关。
Subcortical deep gray matter pathology in patients with multiple sclerosis is associated with white matter lesion burden and atrophy but not with cortical atrophy: a diffusion tensor MRI study.
作者信息
Cappellani R, Bergsland N, Weinstock-Guttman B, Kennedy C, Carl E, Ramasamy D P, Hagemeier J, Dwyer M G, Patti F, Zivadinov R
机构信息
From the Buffalo Neuroimaging Analysis Center (R.C., N.B., C.K., E.C., D.P.R., J.H., M.G.D., R.Z.)Department GF Ingrassia, Section of Neurosciences (R.C., F.P.), University of Catania, Catania, Italy.
From the Buffalo Neuroimaging Analysis Center (R.C., N.B., C.K., E.C., D.P.R., J.H., M.G.D., R.Z.).
出版信息
AJNR Am J Neuroradiol. 2014 May;35(5):912-9. doi: 10.3174/ajnr.A3788. Epub 2013 Dec 12.
BACKGROUND AND PURPOSE
The association between subcortical deep gray matter, white matter, and cortical pathology is not well understood in MS. The aim of this study was to use DTI to investigate the subcortical deep gray matter alterations and their relationship with lesion burden, white matter, and cortical atrophy in patients with MS and healthy control patients.
MATERIALS AND METHODS
A total of 210 patients with relapsing-remitting MS, 75 patients with progressive MS, and 110 healthy control patients were included in the study. DTI metrics in whole brain, normal-appearing white matter, normal-appearing gray matter, and subcortical deep gray matter structures were compared. The association between DTI metrics of the subcortical deep gray matter structures with lesion burden, normalized white matter volume, and normalized cortical volume was investigated.
RESULTS
DTI measures were significantly different in whole brain, normal-appearing white matter, and normal-appearing gray matter among the groups (P < .01). Significant differences in DTI diffusivity of total subcortical deep gray matter, caudate, thalamus, and hippocampus (P < .001) were found. DTI diffusivity of total subcortical deep gray matter was significantly associated with normalized white matter volume (P < .001) and normalized cortical volume (P = .033) in healthy control patients. In both relapsing and progressive MS groups, the DTI subcortical deep gray matter measures were associated with the lesion burden and with normalized white matter volume (P < .001), but not with normalized cortical volume.
CONCLUSIONS
These findings suggest that subcortical deep gray matter abnormalities are associated with white matter lesion burden and atrophy, whereas cortical atrophy is not associated with microstructural alterations of subcortical deep gray matter structures in patients with MS.
背景与目的
在多发性硬化症（MS）中，皮质下深部灰质、白质与皮质病理之间的关联尚未完全明确。本研究旨在利用扩散张量成像（DTI）研究MS患者及健康对照者皮质下深部灰质的改变及其与病灶负荷、白质和皮质萎缩的关系。
材料与方法
本研究共纳入210例复发缓解型MS患者、75例进展型MS患者和110例健康对照者。比较全脑、正常白质、正常灰质和皮质下深部灰质结构的DTI指标。研究皮质下深部灰质结构的DTI指标与病灶负荷、标准化白质体积和标准化皮质体积之间的关联。
结果
各组间全脑、正常白质和正常灰质的DTI测量值存在显著差异（P <.01）。发现总皮质下深部灰质、尾状核、丘脑和海马的DTI扩散率存在显著差异（P <.001）。在健康对照者中，总皮质下深部灰质的DTI扩散率与标准化白质体积（P <.001）和标准化皮质体积（P =.033）显著相关。在复发型和进展型MS组中，DTI皮质下深部灰质测量值均与病灶负荷和标准化白质体积相关（P <.001），但与标准化皮质体积无关。
结论
这些发现表明，皮质下深部灰质异常与白质病灶负荷和萎缩有关，而在MS患者中，皮质萎缩与皮质下深部灰质结构的微观结构改变无关。
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