Neurology Department, CHU Rennes, Rennes, France.
Univ Rennes, CHU Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, VISAGES (Vision, Action Et Gestion Des Informations en santé), ERL U 1228, 35000, Rennes, France.
J Neurol. 2019 Sep;266(9):2294-2303. doi: 10.1007/s00415-019-09419-5. Epub 2019 Jun 7.
In patients with MS, the effect of structural damage to the corticospinal tract (CST) has been separately evaluated in the brain and spinal cord (SC), even though a cumulative impact is suspected.
To evaluate CST damages on both the cortex and cervical SC, and examine their relative associations with motor function, measured both clinically and by electrophysiology.
We included 43 patients with early relapsing-remitting MS. Lesions were manually segmented on SC (axial T2*) and brain (3D FLAIR) scans. The CST was automatically segmented using an atlas (SC) or tractography (brain). Lesion volume fractions and diffusion parameters were calculated for SC, brain and CST. Central motor conduction time (CMCT) and triple stimulation technique amplitude ratio were measured for 42 upper limbs, from 22 patients.
Mean lesion volume fractions were 5.2% in the SC portion of the CST and 0.9% in the brain portion. We did not find a significant correlation between brain and SC lesion volume fraction (r = 0.06, p = 0.68). The pyramidal EDSS score and CMCT were both significantly correlated with the lesion fraction in the SC CST (r = 0.39, p = 0.01 and r = 0.33, p = 0.03), but not in the brain CST.
Our results highlight the major contribution of SC lesions to CST damage and motor function abnormalities.
在多发性硬化症（MS）患者中，皮质脊髓束（CST）的结构损伤在大脑和脊髓（SC）中分别进行了评估，尽管怀疑存在累积影响。
评估 CST 在皮质和颈段 SC 上的损伤，并检查其与运动功能的相对关联，这些功能通过临床和电生理学来测量。
我们纳入了 43 例早期复发缓解型 MS 患者。使用手动分割方法对 SC（轴向 T2*）和大脑（3D FLAIR）扫描中的病变进行分割。使用图谱（SC）或轨迹图（大脑）自动分割 CST。计算 SC、大脑和 CST 的病变体积分数和扩散参数。从 22 名患者的 42 个上肢中测量中央运动传导时间（CMCT）和三重刺激技术幅度比。
CST 的 SC 部分的平均病变体积分数为 5.2%，大脑部分为 0.9%。我们未发现大脑和 SC 病变体积分数之间存在显著相关性（r=0.06，p=0.68）。锥体 EDSS 评分和 CMCT 均与 SC CST 的病变分数显著相关（r=0.39，p=0.01 和 r=0.33，p=0.03），但与大脑 CST 无关。
我们的结果强调了 SC 病变对 CST 损伤和运动功能异常的主要贡献。
