Mallik Shahrukh, Muhlert Nils, Samson Rebecca S, Sethi Varun, Wheeler-Kingshott Claudia A M, Miller David H, Chard Declan T
NMR Research Unit, University College London, UK
NMR Research Unit, University College London, UK/School of Psychology: Cardiff University, UK.
Mult Scler. 2015 Apr;21(4):423-32. doi: 10.1177/1352458514546513. Epub 2014 Aug 21.
In multiple sclerosis (MS), demyelination and neuro-axonal loss occur in the brain grey matter (GM). We used magnetic resonance imaging (MRI) measures of GM magnetisation transfer ratio (MTR) and volume to assess the regional localisation of reduced MTR (reflecting demyelination) and atrophy (reflecting neuro-axonal loss) in relapsing-remitting MS (RRMS), secondary progressive MS (SPMS) and primary progressive MS (PPMS).
A total of 98 people with MS (51 RRMS, 28 SPMS, 19 PPMS) and 29 controls had T1-weighted volumetric and magnetisation transfer scans. SPM8 was used to undertake voxel-based analysis (VBA) of GM tissue volumes and MTR. MS subgroups were compared with controls, adjusting for age and gender. A voxel-by-voxel basis correlation analysis between MTR and volume within each subject group was performed, using biological parametric mapping.
MTR reduction was more extensive than atrophy. RRMS and SPMS patients showed proportionately more atrophy in the deep GM. SPMS and PPMS patients showed proportionately greater cortical MTR reduction. RRMS patients demonstrated the most correlation of MTR reduction and atrophy in deep GM. In SPMS and PPMS patients, there was less extensive correlation.
These results suggest that in the deep GM of RRMS patients, demyelination and neuro-axonal loss may be linked, while in SPMS and PPMS patients, neuro-axonal loss and demyelination may occur mostly independently.
在多发性硬化症（MS）中，脑灰质（GM）会发生脱髓鞘和神经轴突损失。我们使用磁共振成像（MRI）测量脑灰质磁化传递率（MTR）和体积，以评估复发缓解型MS（RRMS）、继发进展型MS（SPMS）和原发进展型MS（PPMS）中MTR降低（反映脱髓鞘）和萎缩（反映神经轴突损失）的区域定位。
共有98例MS患者（51例RRMS、28例SPMS、19例PPMS）和29名对照者接受了T1加权容积和磁化传递扫描。使用SPM8对脑灰质组织体积和MTR进行基于体素的分析（VBA）。将MS亚组与对照者进行比较，并对年龄和性别进行校正。使用生物参数映射对每个受试者组内的MTR和体积进行逐体素相关性分析。
MTR降低比萎缩更广泛。RRMS和SPMS患者在深部脑灰质中显示出比例更高的萎缩。SPMS和PPMS患者在皮质的MTR降低比例更大。RRMS患者在深部脑灰质中MTR降低与萎缩的相关性最强。在SPMS和PPMS患者中，相关性范围较小。
这些结果表明，在RRMS患者的深部脑灰质中，脱髓鞘和神经轴突损失可能有关联，而在SPMS和PPMS患者中，神经轴突损失和脱髓鞘可能大多独立发生。
