Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Department of Anatomy & Neurosciences, VU University Medical Center (VUmc), Amsterdam, The Netherlands.
Mult Scler. 2018 Nov;24(13):1687-1695. doi: 10.1177/1352458517730132. Epub 2017 Sep 21.
Cerebellar lesions are often reported in relapsing-remitting multiple sclerosis (RRMS) and have been associated with impaired motor function and cognitive status. However, prior research has primarily focused on summary measures of cerebellar involvement (e.g. total lesion load, gray/white matter volume) and not on the effect of lesion load within specific regions of cerebellar white matter.
Spatially map the probability of cerebellar white matter lesion (CWML) occurrence in RRMS and explore the relationship between cognitive impairment and lesion (CWML) location within the cerebellum.
High-resolution structural magnetic resonance imaging (MRI) was acquired on 16 cognitively impaired (CI) and 15 cognitively preserved (CP) RRMS subjects at 3T and used for lesion identification and voxel-based lesion-symptom mapping (VLSM).
CI RRMS demonstrated a predilection for the middle cerebellar peduncle (MCP). VLSM results indicate that lesions of the MCP are significantly associated with CI in RRMS. Measures of cerebellar lesion load were correlated with age at disease onset but not disease duration.
A specific pattern of cerebellar lesions involving the MCP, rather than the total CWML load, contributes to cognitive dysfunction in RRMS. Cerebellar lesion profiles may provide a biomarker of current or evolving risk for cognitive status change in RRMS.
小脑病变在复发缓解型多发性硬化症（RRMS）中经常被报道，并与运动功能和认知状态受损有关。然而，先前的研究主要集中在小脑受累的综合指标上（例如，总病变负荷、灰质/白质体积），而不是小脑白质特定区域的病变负荷的影响。
在 RRMS 中描绘小脑白质病变（CWML）发生的概率，并探索认知障碍与小脑内病变（CWML）位置之间的关系。
对 16 名认知障碍（CI）和 15 名认知正常（CP）RRMS 患者在 3T 上进行高分辨率结构磁共振成像（MRI）采集，并用于病变识别和基于体素的病变-症状映射（VLSM）。
CI RRMS 表现出对小脑中脚（MCP）的偏好。VLSM 结果表明，MCP 的病变与 RRMS 的 CI 显著相关。小脑病变负荷的测量值与疾病发病年龄相关，但与疾病持续时间无关。
涉及 MCP 的特定小脑病变模式，而不是总 CWML 负荷，导致 RRMS 的认知功能障碍。小脑病变特征可能为 RRMS 认知状态变化的当前或潜在风险提供生物标志物。
