Jacobsen Cecilie, Zivadinov Robert, Myhr Kjell-Morten, Dalaker Turi O, Dalen Ingvild, Bergsland Niels, Farbu Elisabeth
Department of Neurology, Stavanger University Hospital, Norway.
Buffalo Neuroimaging Analysis Center, State University of New York, USA.
Mult Scler J Exp Transl Clin. 2020 Jan 27;6(1):2055217320902481. doi: 10.1177/2055217320902481. eCollection 2020 Jan-Mar.
Multiple sclerosis is often associated with unemployment. The contribution of grey matter atrophy to unemployment is unclear.
To identify magnetic resonance imaging biomarkers of grey matter and clinical symptoms associated with unemployment in multiple sclerosis patients.
Demographic, clinical data and 1.5 T magnetic resonance imaging scans were collected in 81 patients at the time of inclusion and after 5 and 10 years. Global and tissue-specific volumes were calculated at each time point. Statistical analysis was performed using a mixed linear model.
At baseline 31 (38%) of the patients were unemployed, at 5-year follow-up 44 (59%) and at 10-year follow-up 34 (81%) were unemployed. The unemployed patients had significantly lower subcortical deep grey matter volume ( < 0.001), specifically thalamus, pallidus, putamen and hippocampal volumes, and cortical volume ( = 0.011); and significantly greater T1 ( < 0.001)/T2 ( < 0.001) lesion volume than the employed patient group at baseline. Subcortical deep grey matter volumes, and to a lesser degree cortical volume, were significantly associated with unemployment throughout the follow-up.
We found significantly greater atrophy of subcortical deep grey matter and cortical volume at baseline and during follow-up in the unemployed patient group. Atrophy of subcortical deep grey matter showed a stronger association to unemployment than atrophy of cortical volume during the follow-up.
多发性硬化症常与失业相关。灰质萎缩对失业的影响尚不清楚。
确定多发性硬化症患者中与失业相关的灰质磁共振成像生物标志物和临床症状。
收集了81例患者纳入时、5年和10年后的人口统计学、临床数据及1.5T磁共振成像扫描结果。在每个时间点计算全脑和特定组织的体积。使用混合线性模型进行统计分析。
基线时31名（38%）患者失业，5年随访时44名（59%）失业，10年随访时34名（81%）失业。失业患者的皮质下深部灰质体积（<0.001）显著降低，特别是丘脑、苍白球、壳核和海马体体积，以及皮质体积（=0.011）；且在基线时，其T1（<0.001）/T2（<0.001）病灶体积显著大于就业患者组。在整个随访过程中，皮质下深部灰质体积，以及程度较轻的皮质体积，与失业显著相关。
我们发现失业患者组在基线和随访期间皮质下深部灰质和皮质体积萎缩明显更大。在随访期间，皮质下深部灰质萎缩与失业的关联比皮质体积萎缩更强。
