多发性硬化症中外侧膝状体核的损伤：评估视觉通路的缺失节点。
Damage of the lateral geniculate nucleus in MS: Assessing the missing node of the visual pathway.
机构信息
From the Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research, and Biomedical Engineering (A. Papadopoulou, L.G., A. Pfister, C.T., M.H., L.K., T.S., S.M.), and Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering (A. Papadopoulou, L.G., A.A., C.T., S.M.), University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (NCRC) (A. Papadopoulou, A.U.B.), and Experimental and Clinical Research Center (A. Papadopoulou, A.U.B.), Max Delbrück Center for Molecular Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; Medical Image Analysis Center (MIAC) (L.G., A.A., C.T., S.M.), Basel, Switzerland; Imeka Solutions (F.M.), Sherbrooke, Canada; Department of Neurology (A.U.B.), University of California Irvine; Cerebral Imaging Centre (M.M.C.), Douglas Mental Health University Institute; Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal; University of Sherbrooke (M.D.), Canada; and Department of Neurology (T.S.), DKD Helios Klinik Wiesbaden, Germany. The present address for L.G. is F. Hoffmann-La Roche, Basel, Switzerland.
出版信息
Neurology. 2019 May 7;92(19):e2240-e2249. doi: 10.1212/WNL.0000000000007450. Epub 2019 Apr 10.
OBJECTIVE
To study if the thalamic lateral geniculate nucleus (LGN) is affected in multiple sclerosis (MS) due to anterograde degeneration from optic neuritis (ON) or retrograde degeneration from optic radiation (OR) pathology, and if this is relevant for visual function.
METHODS
In this cross-sectional study, LGN volume of 34 patients with relapsing-remitting MS and 33 matched healthy controls (HC) was assessed on MRI using atlas-based automated segmentation (MAGeT). ON history, thickness of the ganglion cell-inner plexiform layer (GC-IPL), OR lesion volume, and fractional anisotropy (FA) of normal-appearing OR (NAOR-FA) were assessed as measures of afferent visual pathway damage. Visual function was tested, including low-contrast letter acuity (LCLA) and Hardy-Rand-Rittler (HRR) plates for color vision.
RESULTS
LGN volume was reduced in patients vs HC (165.5 ± 45.5 vs 191.4 ± 47.7 mm, B = -25.89, SE = 5.83, < 0.001). It was associated with GC-IPL thickness (B = 0.95, SE = 0.33, = 0.006) and correlated with OR lesion volume (Spearman ρ = -0.53, = 0.001), and these relationships remained after adjustment for normalized brain volume. There was no association between NAOR-FA and LGN volume (B = -133.28, SE = 88.47, = 0.137). LGN volume was not associated with LCLA (B = 5.5 × 10, SE = 0.03, = 0.998), but it correlated with HRR color vision (ρ = 0.39, = 0.032).
CONCLUSIONS
LGN volume loss in MS indicates structural damage with potential functional relevance. Our results suggest both anterograde degeneration from the retina and retrograde degeneration from the OR lesions as underlying causes. LGN volume is a promising marker reflecting damage of the visual pathway in MS, with the advantage of individual measurement per patient on conventional MRI.
目的
研究多发性硬化症（MS）中是否由于视神经炎（ON）的顺行变性或视辐射（OR）病变的逆行变性而导致外侧膝状体核（LGN）受到影响，以及这是否与视觉功能相关。
方法
在这项横断面研究中，使用基于图谱的自动分割（MAGeT）对 34 名复发缓解型 MS 患者和 33 名匹配的健康对照（HC）的 LGN 体积进行了 MRI 评估。评估了 ON 病史、节细胞内丛状层（GC-IPL）厚度、OR 病变体积和正常表现 OR（NAOR-FA）的各向异性分数（FA），作为传入视觉通路损伤的指标。测试了视觉功能，包括低对比度字母视力（LCLA）和 Hardy-Rand-Rittler（HRR）彩色视力板。
结果
与 HC 相比，患者的 LGN 体积减少（165.5 ± 45.5 与 191.4 ± 47.7 mm，B = -25.89，SE = 5.83，< 0.001）。它与 GC-IPL 厚度相关（B = 0.95，SE = 0.33，= 0.006），与 OR 病变体积相关（Spearman ρ = -0.53，= 0.001），并且这些关系在调整标准化脑体积后仍然存在。NAOR-FA 与 LGN 体积之间无关联（B = -133.28，SE = 88.47，= 0.137）。LGN 体积与 LCLA 无关（B = 5.5×10，SE = 0.03，= 0.998），但与 HRR 颜色视力相关（ρ = 0.39，= 0.032）。
结论
MS 中的 LGN 体积损失表明存在结构损伤，具有潜在的功能相关性。我们的结果表明，视网膜的顺行变性和 OR 病变的逆行变性均可能是潜在的原因。LGN 体积是反映 MS 中视觉通路损伤的有前途的标志物，其优势在于可以在常规 MRI 上为每位患者进行个体测量。
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