Conforti Renata, Cirillo Mario, Sardaro Angela, Caiazzo Giuseppina, Negro Alberto, Paccone Antonella, Sacco Rosaria, Sparaco Maddalena, Gallo Antonio, Lavorgna Luigi, Tedeschi Gioacchino, Cirillo Sossio
Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy.
MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy.
Neuroradiology. 2016 Sep;58(9):859-66. doi: 10.1007/s00234-016-1711-0. Epub 2016 Jul 16.
Fatigue (F) is a common, inexplicable, and disabling symptom in multiple sclerosis (MS) patients. The purpose of this study was to evaluate a possible correlation between fatigue and morpho-volumetric features and site of dilated perivascular spaces (dPS), visible on 3T magnetic resonance (MR) in fatigued multiple sclerosis patients (FMS).
We studied 82 relapsing remitting (RR) FMS patients and 43 HC, matched for age, sex, and education. F was assessed by the Fatigue Severity Scale (FSS). To evaluate a possible correlation between degree of F and characteristics of dPS, patients were divided in two groups: more (mFMS) (FSS ≥ 5; n = 30) and less fatigued (lFMS) (FSS ≥ 4; n = 52), compared to a matched healthy control (HC) subject group. The MR study was performed with 3T scanner by SpinEcho T1, Fast-SpinEcho DP-T2, FLAIR, and 3D FSPGR T1 sequences. dPS volumes were measured with Medical Image Processing Analysis and Visualization (MIPAV); Global Cerebral Atrophy (GCA), expressed as Brain Parenchymal Fraction (BPF), was assessed by FSL SIENAX.
The t test showed significantly increased dPS number (p = 0.021) in FMS patients (mFMS p = 0.0024 and lFMS p = 0.033) compared to HC. Pearson correlation revealed a significant correlation between dPS number and FSS (r = 0.208 p = 0.051). Furthermore, the chi-squared test confirms the intragroup (HC, mFMS, lFMS) differences about dPS location (p = 0.01) and size (p = 0.0001).
Our study confirms that PS in MS patients presents with different volumetric and site characteristics as compared to HC; moreover, F severity significantly correlates with dPS number, site, and size.
疲劳是多发性硬化症（MS）患者常见的、难以解释且使人衰弱的症状。本研究旨在评估疲劳与形态学体积特征以及扩张的血管周围间隙（dPS）部位之间可能存在的相关性，这些在疲劳的多发性硬化症患者（FMS）的3T磁共振（MR）图像上可见。
我们研究了82例复发缓解型（RR）FMS患者和43名健康对照者（HC），他们在年龄、性别和教育程度上相匹配。通过疲劳严重程度量表（FSS）评估疲劳程度。为了评估疲劳程度与dPS特征之间可能存在的相关性，将患者分为两组：与匹配的健康对照组（HC）相比，疲劳程度较高（mFMS）（FSS≥5；n = 30）和疲劳程度较低（lFMS）（FSS≥4；n = 52）。使用3T扫描仪通过自旋回波T1、快速自旋回波DP-T2、液体衰减反转恢复序列（FLAIR）和三维扰相梯度回波T1序列进行MR研究。使用医学图像处理分析与可视化（MIPAV）测量dPS体积；通过FSL SIENAX评估以脑实质分数（BPF）表示的全脑萎缩（GCA）。
t检验显示，与HC相比，FMS患者（mFMS p = 0.0024，lFMS p = 0.033）的dPS数量显著增加（p = 0.021）。Pearson相关性分析显示dPS数量与FSS之间存在显著相关性（r = 0.208，p = 0.051）。此外，卡方检验证实了组内（HC、mFMS、lFMS）在dPS位置（p = 0.01）和大小（p = 0.0001）方面的差异。
我们的研究证实，与HC相比，MS患者的PS呈现出不同的体积和部位特征；此外，疲劳严重程度与dPS数量、部位和大小显著相关。
