I Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", piazza Miraglia, 2, 80138, Naples, Italy.
MRI Center "SUN-FISM", University of Campania "Luigi Vanvitelli" and Institute of Diagnosis and Care "Hermitage-Capodimonte", Naples, Italy.
Brain Imaging Behav. 2018 Feb;12(1):20-28. doi: 10.1007/s11682-016-9667-6.
Cognitive impairment (CI), mainly involving attention and processing speed (A-PS), is a common and disabling symptom in multiple sclerosis (MS). Symbol Digit Modalities Test (SDMT) is one of the more sensitive and reliable tests to assess A-PS deficits in MS. Structural MRI correlates of A-PS in MS still need to be clarified. This study aimed to investigate, in a large group of MS patients, the relationship between regional gray matter (GM) atrophy and SDMT performance. 125 relapsing remitting MS patients and 52 healthy controls (HC) underwent a 3 T-MRI protocol including high-resolution 3D-T1 imaging. All subjects underwent a neurological evaluation and SDMT. A Voxel Based Morphometry analysis was performed to assess: 1) correlations between regional GM volume and SDMT performance in MS patients; 2) regional differences in GM volume between MS patients and HC. Thalamic, putamen and cerebellar volumes were also calculated using FIRST tool from the FMRIB Software Library. A linear regression analysis was performed to assess the contribution of each one of these structures to A-PS performance. A significant negative correlation was found between regional GM volume and SDMT score at the level of the thalamus, cerebellum, putamen, and occipital cortex in MS patients. Thalamus, cerebellum and putamen also showed significant GM atrophy in MS patients compared to HC. Thalamic atrophy is also an independent and additional contributor to A-PS deficits in MS patients. These findings support the role of thalamus as the most relevant GM structure subtending A-PS performance in MS, as measured by SDMT.
认知障碍（CI），主要涉及注意力和处理速度（A-PS），是多发性硬化症（MS）中常见且致残的症状。符号数字模态测验（SDMT）是评估 MS 中 A-PS 缺陷的更敏感和可靠的测试之一。MS 中 A-PS 的结构 MRI 相关性仍需阐明。本研究旨在调查大量 MS 患者中，区域灰质（GM）萎缩与 SDMT 表现之间的关系。125 名复发缓解型 MS 患者和 52 名健康对照（HC）接受了 3T-MRI 方案，包括高分辨率 3D-T1 成像。所有受试者均接受了神经学评估和 SDMT。进行了基于体素的形态计量学分析，以评估：1）MS 患者中区域 GM 体积与 SDMT 表现之间的相关性；2）MS 患者与 HC 之间 GM 体积的区域差异。还使用来自 FMRIB 软件库的 FIRST 工具计算了丘脑、壳核和小脑的体积。进行了线性回归分析，以评估这些结构中的每一个对 A-PS 表现的贡献。在 MS 患者中，发现区域 GM 体积与丘脑、小脑、壳核和枕叶皮层的 SDMT 评分呈显著负相关。与 HC 相比，MS 患者的丘脑、小脑和壳核也表现出明显的 GM 萎缩。丘脑萎缩也是 MS 患者 A-PS 缺陷的独立且额外的贡献因素。这些发现支持丘脑作为与 SDMT 测量的 MS 患者 A-PS 表现相关的最相关 GM 结构的作用。
