Pytel Vanesa, Matias-Guiu Jordi A, Matías-Guiu Jorge, Cortés-Martínez Ana, Montero Paloma, Moreno-Ramos Teresa, Arrazola Juan, Carreras José Luis, Cabrera-Martín María Nieves
Department of Neurology, Hospital Clínico San Carlos. San Carlos Health Research Institute (IdISSC) Complutense University of Madrid. Calle Prof. Martín Lagos s/n. 28040. Madrid, Spain.
Department of Neurology, Hospital Clínico San Carlos. San Carlos Health Research Institute (IdISSC) Complutense University of Madrid. Calle Prof. Martín Lagos s/n. 28040. Madrid, Spain.
Mult Scler Relat Disord. 2020 Jan 2;39:101926. doi: 10.1016/j.msard.2020.101926.
To study the clinical, cognitive, and radiological progression of a cohort of patients with MS, taking into account the amyloid PET with F-florbetaben analyses.
Twenty-nine patients with MS were assessed with longitudinal structural MRI and a clinical and comprehensive neuropsychological protocol, with a mean interval between assessments of 18 ± 3.31 months. F-florbetaben PET was performed at baseline. Uptake was analysed in demyelinating plaques (DWM) and normal-appearing white matter (NAWM). Results were correlated with clinical, cognitive and MRI data.
Patients with cognitive decline over the follow-up period showed a lower standardised uptake value ratio in NAWM and lower thalamic volume and a higher lesion load in the baseline MRI. Myelin status was correlated with EDSS and cognitive tests mainly evaluating visuospatial function and working memory. Lower uptake in NAWM at baseline was also associated with a growth in white matter lesion volume over time.
Lower white matter uptake in amyloid PET is associated with cognitive decline and an increase in white matter lesion volume during the follow-up. Our study suggests that F-florbetaben may be a useful biomarker in assessing myelin status in MS, understanding MS pathophysiology, and predicting cognitive outcomes.
考虑采用氟代贝他苯淀粉样蛋白PET分析，研究一组多发性硬化症（MS）患者的临床、认知和影像学进展情况。
对29例MS患者进行了纵向结构MRI检查以及临床和全面的神经心理学评估，评估之间的平均间隔时间为18±3.31个月。在基线时进行氟代贝他苯PET检查。分析脱髓鞘斑块（DWM）和正常外观白质（NAWM）中的摄取情况。结果与临床、认知和MRI数据相关。
在随访期间出现认知下降的患者，其NAWM中的标准化摄取值比率较低，丘脑体积较小，且基线MRI中的病灶负荷较高。髓鞘状态与扩展残疾状态量表（EDSS）以及主要评估视觉空间功能和工作记忆的认知测试相关。基线时NAWM中较低的摄取也与白质病变体积随时间的增加有关。
淀粉样蛋白PET中较低的白质摄取与随访期间的认知下降和白质病变体积增加有关。我们的研究表明，氟代贝他苯可能是评估MS中髓鞘状态、理解MS病理生理学以及预测认知结果的有用生物标志物。
