NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.
National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, London, UK.
Nat Rev Neurol. 2021 Mar;17(3):173-184. doi: 10.1038/s41582-020-00439-8. Epub 2021 Jan 12.
MRI studies have provided valuable insights into the structure and function of neural networks, particularly in health and in classical neurodegenerative conditions such as Alzheimer disease. However, such work is also highly relevant in other diseases of the CNS, including multiple sclerosis (MS). In this Review, we consider the effects of MS pathology on brain networks, as assessed using MRI, and how these changes to brain networks translate into clinical impairments. We also discuss how this knowledge can inform the targeting of MS treatments and the potential future directions for research in this area. Studying MS is challenging as its pathology involves neurodegenerative and focal inflammatory elements, both of which could disrupt neural networks. The disruption of white matter tracts in MS is reflected in changes in network efficiency, an increasingly random grey matter network topology, relative cortical disconnection, and both increases and decreases in connectivity centred around hubs such as the thalamus and the default mode network. The results of initial longitudinal studies suggest that these changes evolve rather than simply increase over time and are linked with clinical features. Studies have also identified a potential role for treatments that functionally modify neural networks as opposed to altering their structure.
MRI 研究为神经网络的结构和功能提供了有价值的见解，特别是在健康和经典神经退行性疾病（如阿尔茨海默病）中。然而，此类工作在中枢神经系统的其他疾病中也非常重要，包括多发性硬化症（MS）。在这篇综述中，我们考虑了 MRI 评估的 MS 病理学对大脑网络的影响，以及这些大脑网络的变化如何转化为临床障碍。我们还讨论了如何利用这些知识来指导 MS 治疗的靶向治疗，以及该领域未来研究的潜在方向。研究 MS 具有挑战性，因为其病理学涉及神经退行性和局灶性炎症元素，两者都可能破坏神经网络。MS 中的白质束中断反映在网络效率的变化、越来越随机的灰质网络拓扑结构、相对皮质分离，以及以丘脑和默认模式网络为中心的连接增加和减少。初步纵向研究的结果表明，这些变化是随着时间的推移而演变的，而不仅仅是增加，并且与临床特征相关。研究还发现，与改变其结构相比，功能上改变神经网络的治疗可能具有潜在作用。
