脑白质病变与继发进展型多发性硬化认知功能障碍相关。
White matter tract abnormalities are associated with cognitive dysfunction in secondary progressive multiple sclerosis.
机构信息
Department of Anatomy & Neurosciences, VU University Medical Centre, Amsterdam, The Netherlands/NMR Research Unit, Queen Square MS Centre, University College London Institute of Neurology, London, UK
NMR Research Unit, Queen Square MS Centre, University College London Institute of Neurology, London, UK/School of Psychology and Cardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, UK/School of Psychological Sciences, University of Manchester, Manchester, UK.
出版信息
Mult Scler. 2016 Oct;22(11):1429-1437. doi: 10.1177/1352458515622694. Epub 2016 Jan 5.
BACKGROUND
While our knowledge of white matter (WM) pathology underlying cognitive impairment in relapsing remitting multiple sclerosis (MS) is increasing, equivalent understanding in those with secondary progressive (SP) MS lags behind.
OBJECTIVE
The aim of this study is to examine whether the extent and severity of WM tract damage differ between cognitively impaired (CI) and cognitively preserved (CP) secondary progressive multiple sclerosis (SPMS) patients.
METHODS
Conventional magnetic resonance imaging (MRI) and diffusion MRI were acquired from 30 SPMS patients and 32 healthy controls (HC). Cognitive domains commonly affected in MS patients were assessed. Linear regression was used to predict cognition. Diffusion measures were compared between groups using tract-based spatial statistics (TBSS).
RESULTS
A total of 12 patients were classified as CI, and processing speed was the most commonly affected domain. The final regression model including demographic variables and radial diffusivity explained the greatest variance of cognitive performance (R = 0.48, p = 0.002). SPMS patients showed widespread loss of WM integrity throughout the WM skeleton when compared with HC. When compared with CP patients, CI patients showed more extensive and severe damage of several WM tracts, including the fornix, superior longitudinal fasciculus and forceps major.
CONCLUSION
Loss of WM integrity assessed using TBSS helps to explain cognitive decline in SPMS patients.
背景
虽然我们对复发缓解型多发性硬化症（MS）认知障碍相关的白质（WM）病理学的了解在不断增加，但对继发进展型（SP）MS 患者的认知障碍的理解却落后了。
目的
本研究旨在探究认知障碍（CI）和认知正常（CP）继发进展型多发性硬化症（SPMS）患者的 WM 束损伤程度和严重程度是否存在差异。
方法
对 30 例 SPMS 患者和 32 例健康对照者（HC）进行常规磁共振成像（MRI）和弥散张量成像（DTI）检查。评估 MS 患者常见的认知域。采用线性回归预测认知功能。采用基于纤维束的空间统计学（TBSS）对两组间的弥散指标进行比较。
结果
共有 12 例患者被归类为 CI，其中以处理速度障碍最为常见。纳入人口统计学变量和放射状弥散率的最终回归模型可以最大程度地解释认知表现的差异（R²=0.48，p=0.002）。与 HC 相比，SPMS 患者 WM 骨架内的 WM 完整性普遍丧失。与 CP 患者相比，CI 患者的多个 WM 束，包括穹窿、胼胝体上束和内囊前肢，损伤更广泛、更严重。
结论
使用 TBSS 评估的 WM 完整性丧失有助于解释 SPMS 患者的认知下降。
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