Moog Tatum M, McCreary Morgan, Stanley Thomas, Wilson Andrew, Santoyo Jose, Wright Katy, Winkler Mandy D, Wang Yeqi, Yu Frank, Newton Braeden D, Zeydan Burcu, Kantarci Orhun, Guo Xiaohu, Okuda Darin T
UT Southwestern Medical Center, Department of Neurology & Neurotherapeutics Neuroinnovation Program, Multiple Sclerosis & Neuroimmunology Imaging Program, Dallas, Texas, U.S.A.
University of Texas at Dallas, Department of Computer Science, Dallas, Texas, U.S.A.
Mult Scler Relat Disord. 2020 Oct;45:102429. doi: 10.1016/j.msard.2020.102429. Epub 2020 Jul 28.
To compare the temporal changes in the 3-dimensional (3D) structure of the medulla-upper cervical spinal cord region in African American (AA) and white multiple sclerosis (MS) patients to identify early patterns of anatomical change prior to progressive symptom development.
Standardized 3-Tesla 3D brain MRI studies were performed at two time points on AA and white MS patients along with controls. Longitudinal changes in volume, surface area, tissue compliance, and surface texture measured in total and within ventral and dorsal compartments were studied. Independent regression models were constructed to evaluate differences between groups.
Thirty-five individuals were studied, 10 AA with MS (female (F): 8; median age [IQR]=33.8 years (y) [10.9], median disease duration: 11.8y [11.3]), 20 white MS patients (F: 10; 35.6y [17.4], 7.23y [8.83], and 5 controls (F: 2, 51.8y [10.2]). Expanded Disability Status Scale scores were 0.0 at baseline and at the second MRI time point. Within the medulla-upper cervical spinal cord, AA versus white MS patients exhibited greater rates of atrophy in total (p<0.0001) and within the ventral (p<0.0001) and dorsal (p<0.0001) compartments, reduced surface area (p<0.0001), and reduced tissue compliance in the ventral (p=0.002) and dorsal (p=0.0005) compartments. The rate of change at the dorsal surface, but not the ventral surface, between MRI time points was also greater in AA relative to white MS patients (p<0.0001).
Structural changes in distinct anatomical regions of the medulla-upper cervical spinal cord may be reflective of early and disproportionate neurodegeneration in AA MS as compared to whites.
比较非裔美国人（AA）和白人多发性硬化症（MS）患者延髓-上颈髓区域三维（3D）结构随时间的变化，以确定在进行性症状出现之前的早期解剖学变化模式。
在两个时间点对AA和白人MS患者以及对照组进行标准化的3特斯拉3D脑部MRI研究。研究了总体积、表面积、组织顺应性和表面纹理在腹侧和背侧隔室中的纵向变化。构建独立回归模型以评估组间差异。
共研究了35名个体，其中10名患有MS的AA患者（女性（F）：8名；年龄中位数[四分位间距]=33.8岁（y）[10.9]，疾病持续时间中位数：11.8y[11.3]），20名白人MS患者（F：10名；35.6y[17.4]，7.23y[8.83]），以及5名对照组（F：2名，51.8y[10,2]）。扩展残疾状态量表评分在基线和第二次MRI时间点均为0.0。在延髓-上颈髓内，AA与白人MS患者相比，总体（p<0.0001）以及腹侧（p<0.0001）和背侧（p<0.0001）隔室的萎缩率更高，表面积减小（p<0.0001），腹侧（p=0.002）和背侧（p=0.0005）隔室的组织顺应性降低。与白人MS患者相比，AA患者在MRI时间点之间背侧表面（而非腹侧表面）的变化率也更高（p<0.0001）。
与白人相比，AA型MS患者延髓-上颈髓不同解剖区域的结构变化可能反映了早期且不成比例的神经退行性变。
