Krämer Julia, Meuth Sven G, Tenberge Jan-Gerd, Schiffler Patrick, Wiendl Heinz, Deppe Michael
Department of Neurology, Westfälische Wilhelms University, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Münster, Germany.
Int J Mol Sci. 2015 Sep 25;16(10):23195-209. doi: 10.3390/ijms161023195.
Putamen atrophy and its long-term progress during disease course were recently shown in patients with multiple sclerosis (MS). Here we investigated retrospectively the time point of atrophy onset in patients with relapsing-remitting MS (RRMS). 68 patients with RRMS and 26 healthy controls (HC) were admitted to 3T MRI in a cross-sectional study. We quantitatively analyzed the putamen volume of individual patients in relation to disease duration by correcting for age and intracranial volume (ICV). Patient's relative putamen volume (RPV), expressed in percent of ICV, was significantly reduced compared to HC. Based on the correlation between RPV and age, we computed the age-corrected RPV deviation (ΔRPV) from HC. Patients showed significantly negative ΔRPV. Interestingly, the age-corrected ΔRPV depended logarithmically on disease duration: Directly after first symptom manifestation, patients already showed a reduced RPV followed by a further degressive volumetric decline. This means that atrophy progression was stronger in the first than in later years of disease. Putamen atrophy starts directly after initial symptom manifestation or even years before, and progresses in a degressive manner. Due to its important role in neurological functions, early detection of putamen atrophy seems necessary. High-resolution structural MRI allows monitoring of disease course.
壳核萎缩及其在病程中的长期进展最近在多发性硬化症（MS）患者中得到了证实。在此，我们回顾性研究了复发缓解型多发性硬化症（RRMS）患者萎缩开始的时间点。在一项横断面研究中，68例RRMS患者和26名健康对照者（HC）接受了3T磁共振成像（MRI）检查。我们通过校正年龄和颅内体积（ICV），定量分析了个体患者的壳核体积与病程的关系。以ICV的百分比表示的患者相对壳核体积（RPV）与HC相比显著降低。基于RPV与年龄之间的相关性，我们计算了与HC相比的年龄校正后的RPV偏差（ΔRPV）。患者显示出显著的负ΔRPV。有趣的是，年龄校正后的ΔRPV对数依赖于病程：在首次症状出现后，患者的RPV就已经降低，随后体积进一步递减。这意味着萎缩进展在疾病的最初几年比后期更强烈。壳核萎缩在初始症状出现后或甚至在症状出现前数年就直接开始，并以递减的方式进展。由于其在神经功能中的重要作用，壳核萎缩的早期检测似乎是必要的。高分辨率结构MRI能够监测病程。
