Király András, Kincses Zsigmond Tamás, Szabó Nikoletta, Tóth Eszter, Csete Gergő, Faragó Péter, Vécsei László
Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
Ideggyogy Sz. 2016 Jul 30;69(7-8):261-267. doi: 10.18071/isz.69.0261.
Background - Huntington's disease is a progressive disease in which neurodegeneration is on-going from the early presymptomatic phase. Development of sensitive biomarkers in this presymptomatic stage that are able to monitor the disease progression and test the efficacy of putative neuroprotective treatments are essential.
Methods - Seven presymptomatic Huntington mutation carriers and ten age-matched healthy controls were recruited. Six of the patients participated in a 24 months longitudinal study having MRI scans 12 and 24 months after the baseline measurements. High resolution T1 weighted images were carried out and voxel based morphometry was used to analyse the data. Apart of group differences, correlation of CAG repeat number with focal cortical thickness and with global gray matter volume was calculated.
Results - Focal cortical atrophy was found bilaterally in the superior temporal sulcus and in the left middle frontal gyrus in presymptomatic Huntington patients in whom no sign of cognitive or motor deterioration was detected. Global gray matter atrophy (p<0.048) and decreased total brain volume was found. The number of CAG triplets showed no correlation with the focal gray matter atrophy and total brain volume. Strong correlation between the CAG repeat number and global gray matter volume was found (p<0.016).
Conclusion - Cortical atrophy is apparent in the early, presymptomatic stage of the disease. With further validation in large patient sample atrophy measure could be biomarker of disease progression and putatively of neurodegeneration.
背景 - 亨廷顿舞蹈症是一种进行性疾病,在症状出现前的早期阶段神经退行性变就已持续发生。在这个症状出现前阶段开发能够监测疾病进展并测试假定神经保护治疗效果的敏感生物标志物至关重要。
方法 - 招募了7名症状出现前的亨廷顿突变携带者和10名年龄匹配的健康对照者。其中6名患者参与了一项为期24个月的纵向研究,在基线测量后12个月和24个月进行了MRI扫描。进行了高分辨率T1加权成像,并使用基于体素的形态计量学分析数据。除了组间差异外,还计算了CAG重复次数与局灶性皮质厚度以及与全脑灰质体积的相关性。
结果 - 在未检测到认知或运动功能恶化迹象的症状出现前的亨廷顿患者中,双侧颞上沟和左侧额中回发现局灶性皮质萎缩。发现全脑灰质萎缩(p<0.048)和全脑体积减小。CAG三联体的数量与局灶性灰质萎缩和全脑体积无相关性。发现CAG重复次数与全脑灰质体积之间存在强相关性(p<0.016)。
结论 - 皮质萎缩在疾病的早期症状出现前阶段就很明显。通过在大量患者样本中进一步验证,萎缩测量可能成为疾病进展以及推测的神经退行性变的生物标志物。