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多发性硬化症患者深部灰质中铁蓄积的决定因素。

Determinants of iron accumulation in deep grey matter of multiple sclerosis patients.

作者信息

Ropele Stefan, Kilsdonk Iris D, Wattjes Mike P, Langkammer Christian, de Graaf Wolter L, Frederiksen Jette L, Larsson Henrik B, Yiannakas Marios, Wheeler-Kingshott Claudia Am, Enzinger Christian, Khalil Michael, Rocca Maria A, Sprenger Till, Amann Michael, Kappos Ludwig, Filippi Massimo, Rovira Alex, Ciccarelli Olga, Barkhof Frederik, Fazekas Franz

机构信息

Medical University of Graz, Auenbruggerplatz 22, 8036 Graz, Austria

VU University Medical Center, The Netherlands.

出版信息

Mult Scler. 2014 Nov;20(13):1692-8. doi: 10.1177/1352458514531085. Epub 2014 Apr 30.

Abstract

BACKGROUND

Iron accumulation in deep grey matter (GM) structures is a consistent finding in multiple sclerosis (MS) patients. This study focused on the identification of independent determinants of iron accumulation using R2* mapping.

SUBJECTS AND METHODS

Ninety-seven MS patients and 81 healthy controls were included in this multicentre study. R2* mapping was performed on 3T MRI systems. R2*in deep GM was corrected for age and was related to disease duration, disability, T2 lesion load and brain volume.

RESULTS

Compared to controls, R2* was increased in all deep GM regions of MS patients except the globus pallidus and the substantia nigra. R2* increase was most pronounced in the progressive stage of the disease and independently predicted by disease duration and disability. Reduced cortical volume was not associated with iron accumulation in the deep GM with the exception of the substantia nigra and the red nucleus. In lesions, R2* was inversely correlated with disease duration and higher total lesion load.

CONCLUSION

Iron accumulation in deep GM of MS patients is most strongly and independently associated with duration and severity of the disease. Additional associations between cortical GM atrophy and deep GM iron accumulation appear to exist in a region specific manner.

摘要

背景

在多发性硬化症(MS)患者中,深部灰质(GM)结构中铁的蓄积是一个一致的发现。本研究聚焦于使用R2* 映射来识别铁蓄积的独立决定因素。

对象与方法

本多中心研究纳入了97例MS患者和81名健康对照。在3T MRI系统上进行R2* 映射。深部GM中的R2* 针对年龄进行了校正,并与疾病持续时间、残疾程度、T2病变负荷和脑容量相关。

结果

与对照组相比,MS患者除苍白球和黑质外的所有深部GM区域的R2* 均升高。R2* 的升高在疾病进展期最为明显,且由疾病持续时间和残疾程度独立预测。除黑质和红核外,皮质体积减小与深部GM中的铁蓄积无关。在病变中,R2* 与疾病持续时间和更高的总病变负荷呈负相关。

结论

MS患者深部GM中的铁蓄积与疾病的持续时间和严重程度最密切且独立相关。皮质GM萎缩与深部GM铁蓄积之间似乎以区域特异性方式存在其他关联。

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