Bakshi Rohit, Neema Mohit, Tauhid Shahamat, Healy Brian C, Glanz Bonnie I, Kim Gloria, Miller Jennifer, Berkowitz Julia L, Bove Riley, Houtchens Maria K, Severson Christopher, Stankiewicz James M, Stazzone Lynn, Chitnis Tanuja, Guttmann Charles R G, Weiner Howard L, Ceccarelli Antonia
aDepartment of Neurology bDepartment of Radiology cLaboratory for Neuroimaging Research, Brigham and Women's Hospital dPartners Multiple Sclerosis Center, Harvard Medical School, Boston, Massachusetts, USA.
Neuroreport. 2014 Oct 1;25(14):1156-61. doi: 10.1097/WNR.0000000000000244.
The objective of this study was to test a new version of the Magnetic Resonance Disease Severity Scale (MRDSS2), incorporating cerebral gray matter (GM) and spinal cord involvement from 3 T MRI, in modeling the relationship between MRI and physical disability or cognitive status in multiple sclerosis (MS). Fifty-five MS patients and 30 normal controls underwent high-resolution 3 T MRI. The patients had an Expanded Disability Status Scale score of 1.6±1.7 (mean±SD). The cerebral normalized GM fraction (GMF), the T2 lesion volume (T2LV), and the ratio of T1 hypointense LV to T2LV (T1/T2) were derived from brain images. Upper cervical spinal cord area (UCCA) was obtained from spinal cord images. A within-subject d-score (difference of MS from normal control) for each MRI component was calculated, equally weighted, and summed to form MRDSS2. With regard to the relationship between physical disability and MRDSS2 or its individual components, MRI-Expanded Disability Status Scale correlations were significant for MRDSS2 (r=0.33, P=0.013) and UCCA (r=-0.33, P=0.015), but not for GMF (P=0.198), T2LV (P=0.707), and T1/T2 (P=0.240). The inclusion of UCCA appeared to drive this MRI-disability relationship in MRDSS2. With regard to cognition, MRDSS2 showed a larger effect size (P=0.035) than its individual components [GMF (P=0.081), T2LV (P=0. 179), T1/T2 (P=0.043), and UCCA (P=0.818)] in comparing cognitively impaired with cognitively preserved patients (defined by the Minimal Assessment of Cognitive Function in MS). Both cerebral lesions (T1/T2) and atrophy (GMF) appeared to drive this relationship. We describe a new version of the MRDSS, which has been expanded to include cerebral GM and spinal cord involvement. MRDSS2 has concurrent validity with clinical status.
本研究的目的是测试新版磁共振疾病严重程度量表（MRDSS2），该量表纳入了来自3T磁共振成像（MRI）的脑灰质（GM）和脊髓受累情况，用于建立多发性硬化症（MS）患者MRI与身体残疾或认知状态之间的关系。55例MS患者和30名正常对照者接受了高分辨率3T MRI检查。患者的扩展残疾状态量表评分为1.6±1.7（均值±标准差）。脑标准化GM分数（GMF）、T2病变体积（T2LV）以及T1低信号病变体积与T2LV的比值（T1/T2）由脑部图像得出。上颈段脊髓面积（UCCA）从脊髓图像中获取。计算每个MRI成分的受试者内d分数（MS与正常对照的差异），给予同等权重并求和以形成MRDSS2。关于身体残疾与MRDSS2或其各个成分之间的关系，MRI与扩展残疾状态量表的相关性在MRDSS2（r = 0.33，P = 0.013）和UCCA（r = -0.33，P = 0.015）方面具有显著性，但在GMF（P = 0.198）、T2LV（P = 0.707）和T1/T2（P = 0.240）方面不具有显著性。UCCA的纳入似乎推动了MRDSS2中这种MRI与残疾的关系。关于认知，在比较认知受损与认知未受损患者（由MS认知功能最小评估定义）时，MRDSS2显示出比其各个成分[GMF（P = 0.081）、T2LV（P = 0.179）、T1/T2（P = 0.043）和UCCA（P = 0.818）]更大的效应量（P = 0.035）。脑病变（T1/T2）和萎缩（GMF）似乎都推动了这种关系。我们描述了一种新版的MRDSS，其已扩展到包括脑GM和脊髓受累情况。MRDSS2与临床状态具有同时效度。
