School of Medicine, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador,
Department of Epidemiology, Gilead Sciences, Inc., Foster City, California, USA.
Eur Neurol. 2020;83(4):421-425. doi: 10.1159/000510076. Epub 2020 Sep 17.
Dawson fingers are used to differentiate multiple sclerosis (MS) from other conditions that affect the subcortical white matter. However, there are no studies evaluating the presence of Dawson fingers in subjects with cerebral small vessel disease (cSVD). We aimed to assess prevalence and -correlates of Dawson fingers in older adults with cSVD-related moderate-to-severe white matter hyperintensities (WMH). Community-dwelling older adults residing in rural Ecuador - identified by means of door-to-door surveys - underwent a brain MRI. Exams of individuals with cSVD-related moderate-to-severe WMH were reviewed with attention to the presence of Dawson fingers. Of 590 enrolled individuals, 172 (29%) had moderate-to-severe WMH. Of these, 18 (10.5%) had Dawson fingers. None had neurological manifestations suggestive of MS. Increasing age was independently associated with Dawson fingers (p = 0.017). Dawson fingers may be less specific for MS than previously thought. Concomitant damage of deep medullary veins may explain the presence of Dawson fingers in cSVD.
道森指征用于鉴别多发性硬化（MS）与其他影响皮质下白质的疾病。然而，目前尚无研究评估脑小血管病（cSVD）患者道森指征的存在情况。我们旨在评估伴有 cSVD 相关中重度脑白质高信号（WMH）的老年患者道森指征的患病率及其相关因素。通过挨家挨户调查，确定居住在厄瓜多尔农村的社区老年人，对他们进行脑部 MRI 检查。对患有 cSVD 相关中重度 WMH 的患者进行检查，注意观察是否存在道森指征。在 590 名入组的患者中，有 172 名（29%）患有中重度 WMH。其中，有 18 名（10.5%）患有道森指征。没有患者出现提示 MS 的神经症状。年龄增长与道森指征独立相关（p = 0.017）。道森指征可能不如以前认为的那样对 MS 具有特异性。深部髓静脉同时受损可能解释了 cSVD 中存在道森指征的原因。
