Solanky Bhavana S, Prados Ferran, Tur Carmen, Yiannakas Marios C, Kanber Baris, Cawley Niamh, Brownlee Wallace, Ourselin Sebastien, Golay Xavier, Ciccarelli Olga, Gandini Wheeler-Kingshott Claudia A M
NMR Research Unit, Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.
Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK.
J Magn Reson Imaging. 2020 Nov;52(5):1429-1438. doi: 10.1002/jmri.27201. Epub 2020 Jun 1.
Associations between brain total sodium concentration, disability, and disease progression have recently been reported in multiple sclerosis. However, such measures in spinal cord have not been reported.
To measure total sodium concentration (TSC) alterations in the cervical spinal cord of people with relapsing-remitting multiple sclerosis (RRMS) and a control cohort using sodium MR spectroscopy (MRS).
Retrospective cohort.
Nineteen people with RRMS and 21 healthy controls.
FIELD STRENGTH/SEQUENCE: 3 T sodium MRS, diffusion tensor imaging, and 3D gradient echo.
Quantification of total sodium concentration in the cervical cord using a reference phantom. Measures of spinal cord cross-sectional area, fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity from H MRI. Clinical assessments of 9-Hole Peg Test, 25-Foot Timed walk test, Paced Auditory Serial Addition Test with 3-second intervals, grip strength, vibration sensitivity, and posturography were performed on the RRMS cohort as well as reporting lesions in the C2/3 area.
Multiple linear regression models were run between sodium and clinical scores, cross-sectional area, and diffusion metrics to establish any correlations.
A significant increase in spinal cord total sodium concentration was found in people with RRMS relative to healthy controls (57.6 ± 18 mmol and 38.0 ± 8.6 mmol, respectively, P < 0.001). Increased TSC correlated with reduced fractional anisotropy (P = 0.034) and clinically with decreased mediolateral stability assessed with posturography (P = 0.045).
Total sodium concentration in the cervical spinal cord is elevated in RRMS. This alteration is associated with reduced fractional anisotropy, which may be due to changes in tissue microstructure and, hence, in the integrity of spinal cord tissue.
1 TECHNICAL EFFICACY STAGE: 2.
最近有报道称，在多发性硬化症中，脑总钠浓度、残疾和疾病进展之间存在关联。然而，尚未有关于脊髓中此类指标的报道。
使用钠磁共振波谱（MRS）测量复发缓解型多发性硬化症（RRMS）患者和对照组人群颈髓中的总钠浓度（TSC）变化。
回顾性队列研究。
19例RRMS患者和21名健康对照者。
场强/序列：3T钠MRS、扩散张量成像和三维梯度回波。
使用参考体模对颈髓中的总钠浓度进行定量分析。通过氢质子磁共振成像测量脊髓横截面积、各向异性分数、平均扩散率、径向扩散率和轴向扩散率。对RRMS队列进行9孔插钉试验、25英尺定时步行试验、3秒间隔的听觉连续加法试验、握力、振动敏感性和姿势描记法等临床评估，并报告C2/3区域的病变情况。
对钠浓度与临床评分、横截面积和扩散指标进行多元线性回归模型分析，以确定它们之间的相关性。
与健康对照者相比，RRMS患者脊髓总钠浓度显著升高（分别为57.6±18 mmol和38.0±8.6 mmol，P<0.001）。TSC升高与各向异性分数降低相关（P = 0.034），在临床上与姿势描记法评估的中外侧稳定性降低相关（P = 0.045）。
RRMS患者颈髓中的总钠浓度升高。这种改变与各向异性分数降低有关，这可能是由于组织微观结构变化，进而脊髓组织完整性改变所致。
1级。技术效能阶段：2级。
