Wu Gregory F, Brier Matthew R, Parks Cassie A-L, Ances Beau M, Van Stavern Gregory P
Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States 2Department of Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States.
Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States.
Invest Ophthalmol Vis Sci. 2015 Apr;56(4):2541-6. doi: 10.1167/iovs.14-16315.
Currently, the ability for imaging to capture brain adaptations to injury that occurs in multiple sclerosis (MS) is limited. In particular, how the brain initially contends with the earliest clinical manifestations of white matter injury has yet to be defined. The purpose of this study was to determine the impact of acute optic neuritis (ON) on resting state functional connectivity magnetic resonance imaging (rs-fcMRI).
Fifteen patients with a clinically isolated syndrome of acute ON were evaluated at an academic center in a prospective study. Subjects were assessed with structural and functional vision measures, including optical coherence tomography (OCT), high- and low-contrast letter acuity testing, and visual fields and quality-of-life measures (VFQ-25). The rs-fcMRI was compared with age- and sex-matched healthy controls.
We observed reduced functional connectivity within the visual system and a loss of anticorrelations between the visual system and nonvisual networks. Stronger functional connectivity between visual regions correlated with better quality of life, as measured by the VFQ-25, and better acuity scores for both high- and low-contrast testing in the affected eye.
The rs-fcMRI functional connectivity changes within (intranetwork) and between (internetwork) resting state networks occur after acute ON, indicating immediate cortical responses to focal inflammatory demyelination. Thus, focal white matter injury in the central nervous system acutely results in widespread network alterations that may lead to functional neurologic changes seen in MS.
目前，影像学捕捉多发性硬化症（MS）中脑对损伤的适应性变化的能力有限。特别是，大脑最初如何应对白质损伤的最早临床表现尚不清楚。本研究的目的是确定急性视神经炎（ON）对静息态功能连接磁共振成像（rs-fcMRI）的影响。
在一个学术中心对15例急性ON临床孤立综合征患者进行前瞻性研究评估。受试者接受了结构和功能视力测量，包括光学相干断层扫描（OCT）、高对比度和低对比度字母视力测试、视野检查以及生活质量测量（VFQ-25）。将rs-fcMRI结果与年龄和性别匹配的健康对照进行比较。
我们观察到视觉系统内功能连接减少，以及视觉系统与非视觉网络之间的反相关性丧失。视觉区域之间更强的功能连接与更好的生活质量相关，这通过VFQ-25测量，并且与患眼高对比度和低对比度测试的更好视力得分相关。
急性ON后，静息态网络内（网络内）和之间（网络间）的rs-fcMRI功能连接发生变化，表明皮质对局灶性炎性脱髓鞘的即时反应。因此，中枢神经系统的局灶性白质损伤急性导致广泛的网络改变，这可能导致MS中出现的功能性神经变化。
