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多发性硬化症患者的成人脑容量:儿童发病的影响。

Adult brain volume in multiple sclerosis: The impact of paediatric onset.

机构信息

Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, Department of Medical Sciences and Public Health, University of Cagliari, Italy.

Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, Department of Medical Sciences and Public Health, University of Cagliari, Italy.

出版信息

Mult Scler Relat Disord. 2018 Apr;21:103-107. doi: 10.1016/j.msard.2018.03.004. Epub 2018 Mar 6.

Abstract

BACKGROUND

Paediatric onset multiple sclerosis (POMS) is associated with reduced brain and deep grey matter volume in comparison with that in healthy controls and individuals with adult onset multiple sclerosis (AOMS). The aim of our study was to evaluate the impact of POMS on adult brain volume with adjustment for other parameters, such as disease duration.

PATIENTS AND METHODS

We recruited 20 POMS and 40 AOMS patients and 20 healthy controls matched for age and sex. All study participants were adults at the time of inclusion in the study. All study subjects underwent brain magnetic resonance imaging (MRI) to evaluate whole brain, white matter, grey matter, cortical, and deep grey matter volumes. Clinical features, such as the Expanded Disability Status Scale (EDSS) score and disease duration, were also assessed.

RESULTS

Brain (p = 0.01), grey matter (p = 0.01), and deep grey matter volume (p = 0.03) was significantly lower in POMS patients than in AOMS patients, while no differences were detected in the volume of white matter or cortical grey matter. A multiple linear regression analysis showed a relationship between brain volume (dependent variable) and the independent variables age (p < 0.000) and paediatric onset (p < 0.001), while other independent variables, including disease duration, sex, and disability, were not significantly different among groups. There were significant differences in thalamic volume among POMS and AOMS patients and healthy controls.

CONCLUSION

Our data support the previous findings that POMS patients have reduced brain and deep grey matter volume, particularly thalamic volume, compared with sex- and age-matched AOMS patients and healthy controls. These findings appear to be independent of disease duration and other clinical features.

摘要

背景

与健康对照者和成人发病多发性硬化症(AOMS)患者相比,儿科发病多发性硬化症(POMS)患者的大脑和深部灰质体积减少。本研究的目的是评估 POMS 对成人脑容量的影响,同时调整其他参数,如疾病持续时间。

患者和方法

我们招募了 20 名 POMS 患者、40 名 AOMS 患者和 20 名年龄和性别匹配的健康对照者。所有研究参与者在纳入研究时均为成年人。所有研究对象均接受脑磁共振成像(MRI)检查,以评估全脑、白质、灰质、皮质和深部灰质体积。还评估了临床特征,如扩展残疾状态量表(EDSS)评分和疾病持续时间。

结果

POMS 患者的脑(p=0.01)、灰质(p=0.01)和深部灰质体积(p=0.03)明显低于 AOMS 患者,而白质或皮质灰质体积无差异。多元线性回归分析显示,脑容量(因变量)与年龄(p<0.000)和儿科发病(p<0.001)等独立变量之间存在关系,而其他独立变量,包括疾病持续时间、性别和残疾,在各组之间无显著差异。POMS 和 AOMS 患者与健康对照者之间的丘脑体积存在显著差异。

结论

我们的数据支持先前的研究结果,即与年龄和性别匹配的 AOMS 患者和健康对照者相比,POMS 患者的脑和深部灰质体积减少,尤其是丘脑体积减少。这些发现似乎与疾病持续时间和其他临床特征无关。

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