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多发性硬化症患者的弥散张量成像研究结果及其与残疾各方面的关系。

Diffusion tensor imaging findings in the multiple sclerosis patients and their relationships to various aspects of disability.

机构信息

Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.

Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.

出版信息

J Neurol Sci. 2018 Aug 15;391:127-133. doi: 10.1016/j.jns.2018.06.007. Epub 2018 Jun 13.

Abstract

BACKGROUND

The aim of the study was to assess microstructural changes within strategic brain regions in multiple sclerosis (MS) patients, using diffusion tensor imaging (DTI), with regard to various aspects of disability.

MATERIAL AND METHODS

The study comprised 50 patients with relapsing-remitting MS (37 women, 13 men, mean age 36.4 yrs) and 27 age- and sex-matched controls. Using DTI, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained within corpus callosum (CC), both thalami (TH) and middle cerebellar peduncles (MCP). Disability was assessed using Expanded Disability Status Scale (EDSS), MS Functional Composite (MSFC), Symbol Digit Modalities Test (SDMT) and Fatigue Severity Scale (FSS). DTI indices were compared between the patients and controls and in the MS group - referred to disability measures.

RESULTS

Significant decrease in FA and increase in ADC within CC and both TH were found in MS patients compared to the controls. DTI indices within CC and TH correlated significantly with SDMT score, and within TH and MCP - with MSFC manual dexterity measure.

CONCLUSIONS

Changes in DTI measures in normal appearing white and grey matter in the MS patients indicate subtle alterations of the tissue integrity. An occult damage to the strategic brain regions may contribute to various aspects of disability due to MS.

摘要

背景

本研究旨在使用弥散张量成像(DTI)评估多发性硬化症(MS)患者的大脑关键区域的微观结构变化,涉及残疾的各个方面。

材料与方法

该研究纳入 50 名复发缓解型 MS 患者(37 名女性,13 名男性,平均年龄 36.4 岁)和 27 名年龄和性别匹配的对照组。通过 DTI,在胼胝体(CC)、两侧丘脑(TH)和小脑中脑脚(MCP)中获得各向异性分数(FA)和表观扩散系数(ADC)值。使用扩展残疾状态量表(EDSS)、MS 功能综合量表(MSFC)、符号数字模态测试(SDMT)和疲劳严重程度量表(FSS)评估残疾程度。比较了患者与对照组之间以及 MS 组中 DTI 指数与残疾测量值的关系。

结果

与对照组相比,MS 患者的 CC 和双侧 TH 中的 FA 降低和 ADC 增加。CC 和 TH 中的 DTI 指数与 SDMT 评分显著相关,而 TH 和 MCP 中的 DTI 指数与 MSFC 手灵巧度测量值显著相关。

结论

MS 患者正常表现的白质和灰质中的 DTI 指标变化表明组织完整性存在细微改变。大脑关键区域的隐匿性损伤可能会导致 MS 患者残疾的各个方面出现问题。

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