Division of Neurology, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
Department of Radiation Physics, Department of Health, Medicine and Caring Sciences Linköping University, Linköping, Sweden.
Acta Neurol Scand. 2020 Nov;142(5):418-427. doi: 10.1111/ane.13282. Epub 2020 Jun 4.
Optical coherence tomography (OCT) could be complementary to magnetic resonance imaging (MRI) of the brain in monitoring course of multiple sclerosis (MS) and clinically isolated syndrome (CIS). Thinning of neurons in ganglion cell-inner plexiform layer (GCIPL) measured by OCT is assumed to be associated with brain atrophy.
To evaluate association of GCIPL with brain parameters detected by quantitative MRI (qMRI) and MR-spectroscopy (MRS) in early MS and CIS.
Seventeen newly diagnosed MS and 18 CIS patients were prospectively included. The patients were assessed at baseline as well as at 1 year follow-up by OCT, qMRI and MRS. Brain parenchymal and myelin volumes (BPV, MYV respectively) and the corresponding fractions (BPF, MYF) were measured with qMRI. Metabolites including myo-inositol (myo-Ins) were measured in the normal-appearing white matter (NAWM) using MRS. T-tests and ANOVA were used to analyze group differences, and linear regression models to evaluate association of GCIPL with BPV, MYV and myo-Ins after correlation analysis.
Disease activity reflected by lesions on MRI and presence of CSF oligoclonal IgG bands were more prominent in MS compared to CIS. GCIPL, BPV, MYV, BPF and MYF were reduced, while concentration of myo-Ins was increased in MS compared to CIS. Follow-up showed consistency of thinner GCIPL in MS compared to CIS. GCIPL thinning correlated with reduced BPV and MYV (P < .05 for both), but with increased myo-Ins (P < .01).
Significant GCIPL thinning occurs in early MS and is associated with enhanced brain inflammation and atrophy.
光学相干断层扫描（OCT）在监测多发性硬化症（MS）和临床孤立综合征（CIS）的病程方面可能与脑部磁共振成像（MRI）互补。OCT 测量的神经节细胞-内丛状层（GCIPL）变薄被认为与脑萎缩有关。
评估 OCT 测量的 GCIPL 与早期 MS 和 CIS 定量 MRI（qMRI）和磁共振波谱（MRS）检测到的脑参数之间的相关性。
前瞻性纳入 17 例新诊断的 MS 和 18 例 CIS 患者。这些患者在基线时以及 1 年随访时接受 OCT、qMRI 和 MRS 评估。使用 qMRI 测量脑实质和髓鞘容积（BPV、MYV 分别）和相应分数（BPF、MYF）。使用 MRS 在正常表现的白质（NAWM）中测量代谢物，包括肌醇（myo-Ins）。使用 T 检验和方差分析比较组间差异，使用线性回归模型在相关性分析后评估 GCIPL 与 BPV、MYV 和 myo-Ins 的相关性。
与 CIS 相比，MS 患者 MRI 上的病变和 CSF 寡克隆 IgG 带反映的疾病活动更明显。与 CIS 相比，MS 患者的 GCIPL、BPV、MYV、BPF 和 MYF 减少，而肌醇浓度增加。随访发现 MS 患者的 GCIPL 变薄较 CIS 更一致。GCIPL 变薄与 BPV 和 MYV 减少相关（均 P <.05），但与肌醇增加相关（P <.01）。
早期 MS 患者出现明显的 GCIPL 变薄，与脑内炎症和萎缩增强有关。
