Singh Sonika, Tench Christopher R, Tanasescu Radu, Constantinescu Cris S
Division of Clinical Neuroscience, Clinical Neurology, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK.
NIHR Nottingham Biomedical Research Centre, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK.
Brain Sci. 2020 Oct 30;10(11):798. doi: 10.3390/brainsci10110798.
Atrophy of grey matter (GM) is observed in the earliest stages of multiple sclerosis (MS) and is associated with cognitive decline and physical disability. Localised GM atrophy in MS can be explored and better understood using magnetic resonance imaging and voxel-based morphometry (VBM). However, results are difficult to interpret due to methodological differences between studies.
Coordinate-based analysis is a way to find the reliably observable results across multiple independent VBM studies. This work uses coordinate-based meta-analysis, meta-analysis of networks, and meta-regression to summarise the evidence from voxel-based morphometry of regional GM hanges in patients with MS and clinically isolated syndrome (CIS), and whether these measured changes are relatable to clinical features.
Thirty-four published articles reporting forty-four independent experiments using VBM for the assessment of GM atrophy between MS or CIS patients and healthy controls were identified. Analysis identified eight clusters of consistent cross-study reporting of localised GM atrophy involving both cortical and subcortical regions. Meta-network analysis identified a network-like pattern indicating that GM loss occurs with some symmetry between hemispheres. Meta-regression analysis indicates a relationship between disease duration or age and the magnitude of reported statistical effect in some deep GM structures.
These results suggest consistency in MRI-detectible regional GM loss across multiple MS studies, and the estimated effect sizes and symmetries can help design prospective studies to test specific hypotheses.
在多发性硬化症（MS）的最早阶段即可观察到灰质（GM）萎缩，且其与认知功能下降和身体残疾有关。利用磁共振成像和基于体素的形态学测量（VBM），可以对MS中的局部GM萎缩进行探索并更好地理解。然而，由于各研究之间方法学上的差异，结果难以解释。
基于坐标的分析是一种在多个独立的VBM研究中找到可靠可观察结果的方法。这项工作使用基于坐标的荟萃分析、网络荟萃分析和荟萃回归，以总结来自MS和临床孤立综合征（CIS）患者区域GM变化的基于体素形态学测量的证据，以及这些测量变化是否与临床特征相关。
共识别出34篇已发表文章，报告了44项使用VBM评估MS或CIS患者与健康对照之间GM萎缩的独立实验。分析确定了8个一致的跨研究报告的局部GM萎缩聚类，涉及皮质和皮质下区域。元网络分析确定了一种类似网络的模式，表明GM丢失在半球之间具有一定的对称性。元回归分析表明疾病持续时间或年龄与一些深部GM结构中报告的统计效应大小之间存在关联。
这些结果表明，在多项MS研究中，MRI可检测到的区域GM丢失具有一致性，估计的效应大小和对称性有助于设计前瞻性研究以检验特定假设。
