Pinter Daniela, Khalil Michael, Pichler Alexander, Langkammer Christian, Ropele Stefan, Marschik Peter B, Fuchs Siegrid, Fazekas Franz, Enzinger Christian
Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, Graz 8036, Austria.
Institute of Physiology, Medical University of Graz, Harrachgasse 21, Graz 8010, Austria ; Department of Women's and Children's Health, Karolinska Institute, Gävlegatan 22, Stockholm 11330, Sweden.
Neuroimage Clin. 2015 Mar 5;7:715-20. doi: 10.1016/j.nicl.2015.02.023. eCollection 2015.
While many studies correlated cognitive function with changes in brain morphology in multiple sclerosis (MS), few of them used a multi-parametric approach in a single dataset so far. We thus here assessed the predictive value of different conventional and quantitative MRI-parameters both for overall and domain-specific cognitive performance in MS patients from a single center.
69 patients (17 clinically isolated syndrome, 47 relapsing-remitting MS, 5 secondary-progressive MS) underwent the "Brief Repeatable Battery of Neuropsychological Tests" assessing overall cognition, cognitive efficiency and memory function as well as MRI at 3 Tesla to obtain T2-lesion load (T2-LL), normalized brain volume (global brain volume loss), normalized cortical volume (NCV), normalized thalamic volume (NTV), normalized hippocampal volume (NHV), normalized caudate nuclei volume (NCNV), basal ganglia R2* values (iron deposition) and magnetization transfer ratios (MTRs) for cortex and normal appearing brain tissue (NABT).
Regression models including clinical, demographic variables and MRI-parameters explained 22-27% of variance of overall cognition, 17-26% of cognitive efficiency and 22-23% of memory. NCV, T2-LL and MTR of NABT were the strongest predictors of overall cognitive function. Cognitive efficiency was best predicted by NCV, T2-LL and iron deposition in the basal ganglia. NTV was the strongest predictor for memory function and NHV was particularly related to memory function.
The predictive value of distinct MRI-parameters differs for specific domains of cognitive function, with a greater impact of cortical volume, focal and diffuse white matter abnormalities on overall cognitive function, an additional role of basal ganglia iron deposition on cognitive efficiency, and thalamic and hippocampal volume on memory function. This suggests the usefulness of using multiparametric MRI to assess (micro)structural correlates of different cognitive constructs.
虽然许多研究将认知功能与多发性硬化症（MS）的脑形态变化相关联，但迄今为止，很少有研究在单个数据集中使用多参数方法。因此，我们在此评估了来自单一中心的MS患者中不同传统和定量MRI参数对整体及特定领域认知表现的预测价值。
69名患者（17例临床孤立综合征、47例复发缓解型MS、5例继发进展型MS）接受了“简短可重复神经心理测试组”，以评估整体认知、认知效率和记忆功能，并在3特斯拉进行MRI检查，以获取T2病变负荷（T2-LL）、标准化脑体积（全脑体积损失）、标准化皮质体积（NCV）、标准化丘脑体积（NTV）、标准化海马体积（NHV）、标准化尾状核体积（NCNV）、基底节R2*值（铁沉积）以及皮质和正常脑组织（NABT）的磁化传递率（MTR）。
包括临床、人口统计学变量和MRI参数的回归模型解释了整体认知方差的22%-27%、认知效率方差的17%-26%以及记忆方差的22%-23%。NABT的NCV、T2-LL和MTR是整体认知功能的最强预测因子。NCV、T2-LL和基底节铁沉积对认知效率的预测最佳。NTV是记忆功能的最强预测因子，NHV与记忆功能特别相关。
不同MRI参数对特定认知功能领域的预测价值不同，皮质体积、局灶性和弥漫性白质异常对整体认知功能影响更大，基底节铁沉积对认知效率有额外作用，丘脑和海马体积对记忆功能有影响。这表明使用多参数MRI评估不同认知结构的（微观）结构相关性是有用的。
