Hyun J-W, Park G, Kwak K, Jo H-J, Joung A, Kim J-H, Lee S H, Kim S, Lee J-M, Kim S-H, Kim H J
Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang.
Department of Biomedical Engineering, Hanyang University, Seoul.
Eur J Neurol. 2017 Feb;24(2):437-445. doi: 10.1111/ene.13224. Epub 2016 Dec 23.
We investigated changes in deep gray matter (DGM) volume and its relationship to cognition and clinical factors in a large cohort of patients with neuromyelitis optica spectrum disorder (NMOSD) and compared them with results from multiple sclerosis (MS).
Brain magnetic resonance imaging (3 Tesla) and clinical data from 91 patients with NMOSD, 52 patients with MS and 44 healthy controls (HCs) were prospectively evaluated. Differences in DGM volumes were compared among groups. The relationships between DGM atrophy and clinical variables were also analysed.
Patients with NMOSD exhibited significantly reduced thalamic volumes compared with HCs (P = 0.029), although this atrophy was less severe than that seen in patients with MS (P < 0.001). DGM atrophy was restricted to the thalamus in NMOSD, but it was broadly distributed in MS. Patients with NMOSD with cognitive impairment (CI) exhibited more severe thalamic atrophy than those with cognitive preservation (P = 0.017) and HCs (P = 0.003), whereas patients with MS with CI revealed DGM atrophy across the entire structure, with the exception of the bilateral pallidum, left hippocampus and amygdala, relative to HCs. The Expanded Disability Status Scale score was correlated with thalamic atrophy in both NMOSD and MS. Patients with NMOSD with brain lesions demonstrated more severe thalamic atrophy than did those without brain lesions and HCs (P < 0.001).
The DGM atrophy was less severe and more selectively distributed in NMOSD than in MS. Thalamic atrophy was associated with clinical disability, including CI, in both NMOSD and MS.
我们在一大群视神经脊髓炎谱系障碍（NMOSD）患者中研究了深部灰质（DGM）体积的变化及其与认知和临床因素的关系，并将其与多发性硬化症（MS）的结果进行比较。
对91例NMOSD患者、52例MS患者和44例健康对照（HCs）的脑磁共振成像（3特斯拉）和临床数据进行前瞻性评估。比较各组间DGM体积的差异。还分析了DGM萎缩与临床变量之间的关系。
与HCs相比，NMOSD患者的丘脑体积显著减小（P = 0.029），尽管这种萎缩不如MS患者严重（P < 0.001）。NMOSD的DGM萎缩仅限于丘脑，但在MS中分布广泛。有认知障碍（CI）的NMOSD患者比认知功能正常者（P = 0.017）和HCs（P = 0.003）表现出更严重的丘脑萎缩，而有CI的MS患者相对于HCs而言，除双侧苍白球、左侧海马体和杏仁核外，整个结构均有DGM萎缩。扩展残疾状态量表评分与NMOSD和MS中的丘脑萎缩均相关。有脑部病变的NMOSD患者比无脑部病变的患者和HCs表现出更严重的丘脑萎缩（P < 0.001）。
与MS相比，NMOSD的DGM萎缩较轻且分布更具选择性。丘脑萎缩与NMOSD和MS的临床残疾（包括CI）相关。
