Liu Yaou, Dai Zhengjia, Duan Yunyun, Huang Jing, Ren Zhuoqiong, Liu Zheng, Dong Huiqing, Shu Ni, Vrenken Hugo, Wattjes Mike P, Barkhof Frederik, He Yong, Li Kuncheng
Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, People's Republic of China.
Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, 1007 MB, The Netherlands.
Eur Radiol. 2016 Sep;26(9):2982-91. doi: 10.1007/s00330-015-4147-8. Epub 2015 Dec 29.
To investigate brain functional connectivity (FC) alterations in patients with clinically isolated syndromes (CIS) presenting without conventional brain MRI lesions, and to identify the FC differences between the CIS patients who converted to multiple sclerosis (MS) and those not converted during a 5-year follow-up.
We recruited 20 CIS patients without conventional brain lesions, 28 patients with MS and 28 healthy controls (HC). Normalized voxel-based functional connectivity strength (nFCS) was determined using resting-state fMRI (R-fMRI) and compared among groups. Furthermore, 5-years clinical follow-up of the CIS patients was performed to examine the differences in nFCS between converters and non-converters.
Compared to HC, CIS patients showed significantly decreased nFCS in the visual areas and increased nFCS in several brain regions predominately in the temporal lobes. MS patients revealed more widespread higher nFCS especially in deep grey matter (DGM), compared to CIS and HC. In the four CIS patients converting to MS, significantly higher nFCS was found in right anterior cingulate gyrus (ACC) and fusiform gyrus (FG), compared to non-converted patients.
We demonstrated both functional impairment and compensation in CIS by R-fMRI. nFCS alteration in ACC and FG seems to occur in CIS patients at risk of developing MS.
• Both functional impairment and compensation occur in CIS without conventional brain lesions. • MS patients revealed more widespread higher nFCS especially in deep grey matter. • nFCS alteration may help stratifying CIS at risk of developing MS.
研究临床表现为孤立综合征（CIS）且无传统脑磁共振成像（MRI）病变患者的脑功能连接（FC）改变，并确定在5年随访期间转化为多发性硬化症（MS）的CIS患者与未转化患者之间的FC差异。
我们招募了20例无传统脑病变的CIS患者、28例MS患者和28名健康对照者（HC）。使用静息态功能磁共振成像（R-fMRI）确定基于体素的标准化功能连接强度（nFCS），并在各组之间进行比较。此外，对CIS患者进行了5年的临床随访，以检查转化者与未转化者之间nFCS的差异。
与HC相比，CIS患者在视觉区域的nFCS显著降低，而在几个主要位于颞叶的脑区nFCS增加。与CIS和HC相比，MS患者表现出更广泛的较高nFCS，尤其是在深部灰质（DGM）。在转化为MS的4例CIS患者中，与未转化患者相比，右侧前扣带回（ACC）和梭状回（FG）的nFCS显著更高。
我们通过R-fMRI证明了CIS患者存在功能损害和代偿。ACC和FG中的nFCS改变似乎发生在有发展为MS风险的CIS患者中。
• 在无传统脑病变的CIS患者中存在功能损害和代偿。• MS患者表现出更广泛的较高nFCS，尤其是在深部灰质。• nFCS改变可能有助于对有发展为MS风险的CIS患者进行分层。
