Motl Robert W, Hubbard Elizabeth A, Sreekumar Niranjana, Wetter Nathan C, Sutton Bradley P, Pilutti Lara A, Sosnoff Jacob J, Benedict Ralph H B
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, USA.
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, USA.
J Neurol Sci. 2015 Jul 15;354(1-2):33-6. doi: 10.1016/j.jns.2015.04.041. Epub 2015 May 1.
Walking dysfunction is common in multiple sclerosis (MS). The thalamus and basal ganglia seemingly have important associations with walking performance. The contribution of these subcortical gray matter (SGM) structures for walking dysfunction is poorly understood in MS.
This study examined associations among volumes of the thalamus and basal ganglia with walking outcomes in MS.
We enrolled 61 MS patients who underwent brain MRI and completed the 6-minute walk (6MW) and timed 25-foot walk (T25FW). Volumes of the thalamus, caudate, putamen, and pallidum as well as whole-brain white matter (WM) and gray matter (GM) were calculated from 3D T1-weighted structural brain images. We examined associations using bivariate correlations (r) and partial correlations (pr) that controlled for age, MS clinical course, and whole-brain WM and GM volumes. We further performed hierarchical linear regression (HLR) for identifying the strongest SGM correlate of walking performance.
The 6MW and T25FW correlated significantly with volumes of the thalamus (r's=.382 & .383), caudate (r's=.388 & .416), pallidum (r's=.457 & .457), and putamen (r's=.258 & .293) in bivariate correlations. The 6MW and T25FW remained significantly correlated with caudate (pr's=.243 & .312) and pallidum (pr's=.321 & .345) volumes in partial correlations. Pallidum volume was the strongest SGM correlate of 6MW (β=.39) and T25FW (β=.40) performance in HLR.
We provide novel evidence of possible SGM structures, particularly the pallidum and perhaps caudate, as correlates of walking performance in MS.
行走功能障碍在多发性硬化症（MS）中很常见。丘脑和基底神经节似乎与行走表现有重要关联。在MS中，这些皮质下灰质（SGM）结构对行走功能障碍的作用尚不清楚。
本研究探讨了MS患者丘脑和基底神经节体积与行走结果之间的关联。
我们招募了61名接受脑部MRI检查并完成6分钟步行（6MW）和25英尺计时步行（T25FW）的MS患者。从3D T1加权脑部结构图像中计算丘脑、尾状核、壳核和苍白球的体积以及全脑白质（WM）和灰质（GM）的体积。我们使用双变量相关性（r）和控制年龄、MS临床病程以及全脑WM和GM体积的偏相关性（pr）来检验关联。我们进一步进行了分层线性回归（HLR）以确定与行走表现最强相关的SGM。
在双变量相关性中，6MW和T25FW与丘脑体积（r值分别为0.382和0.383）、尾状核（r值分别为0.388和0.416）、苍白球（r值分别为0.457和0.457）以及壳核（r值分别为0.258和0.293）显著相关。在偏相关性中，6MW和T25FW与尾状核体积（pr值分别为0.243和0.312）和苍白球体积（pr值分别为0.321和0.345）仍显著相关。在HLR中，苍白球体积是6MW（β = 0.39）和T25FW（β = 0.40）表现最强的SGM相关因素。
我们提供了新的证据，表明可能的SGM结构，特别是苍白球以及可能的尾状核，与MS中的行走表现相关。
