一项对 RRMS 患者脑萎缩和残疾进展的 10 年随访研究。
A serial 10-year follow-up study of brain atrophy and disability progression in RRMS patients.
机构信息
Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA/MR Imaging Clinical Translational Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA/Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University in Prague, Prague, Czech Republic.
出版信息
Mult Scler. 2016 Nov;22(13):1709-1718. doi: 10.1177/1352458516629769. Epub 2016 Feb 16.
BACKGROUND
We explored the evolution of brain atrophy in relation to development of confirmed disability progression (CDP) on serial 1.5T magnetic resonance imaging (MRI) scans over a 10-year period in 181 patients with early relapsing-remitting multiple sclerosis (RRMS).
METHODS
At 10-year follow-up, they were divided into those with (100) or without (76) CDP (confirmed after 48 weeks). Changes in whole brain (WB), cortical, gray matter (GM), white matter, and ventricular cerebrospinal fluid (vCSF) volumes were calculated on three-dimensional T1-weighted (3D-T1) scans between all available time points.
RESULTS
In multiple sclerosis (MS) patients with CDP compared to those without, the greatest effect size percentage volume change from baseline to follow-up was detected for WB (d = 0.55, -7.5% vs -5.2%, p < 0.001), followed by vCSF (d = 0.51, +41.1% vs +25.7%, p < 0.001), cortical (d = 0.49, -7.7% vs -6.2%, p = 0.001), and GM (d = 0.40, -7.1% vs -5.8%, p = 0.006) volumes. Mixed-effects model analysis, adjusted for age, sex, and treatment change, showed significant interactions between CDP status and percentage changes for WB and vCSF (p < 0.001), cortical (p = 0.02), and GM (p = 0.04) volumes.
CONCLUSIONS
WB and cortical atrophy, and enlargement of vCSF spaces are associated with development of CDP on serial yearly MRI assessments over a period of 10 years.
背景
我们通过对 181 例早期复发缓解型多发性硬化症（RRMS）患者连续 10 年的 1.5T 磁共振成像（MRI）扫描进行分析，探索了脑萎缩与确诊残疾进展（CDP）之间的关系。
方法
在 10 年的随访中，他们被分为有（100 例）或无（76 例）CDP（48 周后确诊）。在三维 T1 加权（3D-T1）扫描中，计算了所有可用时间点之间的全脑（WB）、皮质、灰质（GM）、白质和脑室脑脊液（vCSF）容积的变化。
结果
与无 CDP 的患者相比，在有 CDP 的 MS 患者中，从基线到随访的体积变化的最大效应量百分比在 WB 中检测到（d=0.55，-7.5%对-5.2%，p<0.001），其次是 vCSF（d=0.51，+41.1%对+25.7%，p<0.001）、皮质（d=0.49，-7.7%对-6.2%，p=0.001）和 GM（d=0.40，-7.1%对-5.8%，p=0.006）体积。混合效应模型分析，调整了年龄、性别和治疗变化，显示 CDP 状态与 WB 和 vCSF（p<0.001）、皮质（p=0.02）和 GM（p=0.04）体积的百分比变化之间存在显著的交互作用。
结论
在连续 10 年的每年 MRI 评估中，WB 和皮质萎缩以及 vCSF 空间的扩大与 CDP 的发展相关。
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