迟发性多发性硬化症与更严重的脑室扩张有关。
Late onset multiple sclerosis is associated with more severe ventricle expansion.
作者信息
Jakimovski Dejan, Dujmic Dora, Hagemeier Jesper, Ramasamy Deepa P, Bergsland Niels, Dwyer Michael G, Eckert Svetlana, Kolb Channa, Lizarraga Alexis, Hojnacki David, Weinstock-Guttman Bianca, Zivadinov Robert
机构信息
Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
出版信息
Mult Scler Relat Disord. 2020 Nov;46:102588. doi: 10.1016/j.msard.2020.102588. Epub 2020 Oct 17.
BACKGROUND
Late-onset multiple sclerosis (LOMS) is associated with faster disability progression than persons with adult-onset MS (PwAOMS). The differences in brain atrophy are currently unknown.
OBJECTIVES
To determine MRI-derived atrophy rates in persons with late-onset MS (PwLOMS) and compare them to an age-matched and disease duration-matched sample of PwAOMS.
METHODS
870 persons with MS (290 PwLOMS, 290 age-matched PwAOMS, and 290 disease duration-matched PwAOMS), and 150 healthy controls (HCs), were followed for 5 years and 3 years, respectively. Cross-sectional and longitudinal measures of T2-lesion volume (LV), lateral ventricular volume (LVV) and whole brain volume (WBV) were derived. Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Severity Score (MSSS) were calculated. Both analyses were corrected for false discovery rate.
RESULTS
Persons with MS exhibited significantly greater annualized WBV loss (-0.88% vs. -0.38%, p<0.001) and annualized LVV expansion (3.1% vs. 1.7%, p=0.002) when compared to HCs. PwLOMS had significantly higher baseline and follow-up median MSSS when compared to both age-matched and disease duration-matched PwAOMS (p<0.026). PwLOMS showed significantly greater percent LVV change (14.3% vs. 9.3% p=0.001) and greater annualized percent LVV change (4.1% vs. 1.6%, p<0.001) compared to age-matched PwAOMS.
CONCLUSION
PwLOMS had higher MSSS and greater ventricle expansion when compared to PwAOMS.
背景
晚发型多发性硬化症（LOMS）患者的残疾进展速度比成人发病型多发性硬化症（AOMS）患者更快。目前尚不清楚脑萎缩的差异情况。
目的
确定晚发型多发性硬化症（PwLOMS）患者基于磁共振成像（MRI）得出的萎缩率，并将其与年龄匹配和病程匹配的AOMS患者样本进行比较。
方法
分别对870例多发性硬化症患者（290例PwLOMS、290例年龄匹配的PwAOMS和290例病程匹配的PwAOMS）以及150名健康对照者（HCs）进行了5年和3年的随访。得出了T2病灶体积（LV）、侧脑室体积（LVV）和全脑体积（WBV）的横断面和纵向测量值。计算了扩展残疾状态量表（EDSS）和多发性硬化症严重程度评分（MSSS）。两项分析均针对错误发现率进行了校正。
结果
与HCs相比，多发性硬化症患者的年化WBV损失显著更大（-0.88%对-0.38%，p<0.001），年化LVV扩张也显著更大（3.1%对1.7%，p=0.002）。与年龄匹配和病程匹配的PwAOMS相比，PwLOMS的基线和随访时的MSSS中位数显著更高（p<0.026）。与年龄匹配的PwAOMS相比，PwLOMS的LVV变化百分比显著更大（14.3%对9.3%，p=0.001），年化LVV变化百分比也更大（4.1%对1.6%，p<0.001）。
结论
与PwAOMS相比，PwLOMS的MSSS更高，脑室扩张更大。
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