Sorbonne University, Paris Brain Institute, ICM, Pitié Salpêtrière Hospital, Inserm UMR S 1127, CNRS UMR 7225, Paris, France.
Sorbonne University, Paris Brain Institute, ICM, Pitié Salpêtrière Hospital, Inserm UMR S 1127, CNRS UMR 7225, Paris, France / Paris-Saclay University, CEA, CNRS, Inserm, BioMaps, Service Hospitalier Fréderic Joliot, Orsay, France.
Mult Scler. 2021 Apr;27(4):528-538. doi: 10.1177/1352458520921362. Epub 2020 Jun 17.
Diffusion-weighted H magnetic resonance spectroscopy (DW-MRS) allows to quantify creatine-phosphocreatine brain diffusivity (ADC(tCr)), whose reduction in multiple sclerosis (MS) has been proposed as a proxy of energy dysfunction.
To investigate whether thalamic ADC(tCr) changes are associated with thalamo-cortical tract damage in MS.
Twenty patients with MS and 13 healthy controls (HC) were enrolled in a DW-MRS and DW imaging (DWI) study. From DW-MRS, ADC(tCr) and total N-acetyl-aspartate diffusivity (ADC(tNAA)) were extracted in the thalami. Three thalamo-cortical tracts and one non-thalamic control tract were reconstructed from DWI. Fractional anisotropy (FA), mean (MD), axial (AD), and radial diffusivity (RD), reflecting microstructural integrity, were extracted for each tract. Associations between thalamic ADC(tCr) and tract metrics were assessed using linear regression models adjusting for age, sex, thalamic volume, thalamic ADC(tNAA), and tract-specific lesion load.
Lower thalamic ADC(tCr) was associated with higher MD and RD of thalamo-cortical projections in MS (MD: = 0.029; RD: = 0.017), but not in HC (MD: = 0.625, interaction term between thalamic ADC(tCr) and group = 0.019; RD: = 0.320, interaction term = 0.05). Thalamic ADC(tCr) was not associated with microstructural changes of the control tract.
Reduced thalamic ADC(tCr) correlates with thalamo-cortical tract damage in MS, showing that pathologic changes in thalamic energy metabolism are associated with structural degeneration of connected fibers.
弥散加权磁共振波谱（DW-MRS）可定量检测肌酸磷酸肌酸脑扩散系数（ADC(tCr)），其在多发性硬化症（MS）中的降低被认为是能量功能障碍的替代指标。
探讨 MS 患者丘脑 ADC(tCr)变化与丘脑皮质束损伤的关系。
本研究纳入 20 例 MS 患者和 13 名健康对照者（HC）进行 DW-MRS 和弥散加权成像（DWI）研究。从 DW-MRS 中提取丘脑 ADC(tCr)和总 N-乙酰天门冬氨酸扩散系数（ADC(tNAA)）。从 DWI 中重建三条丘脑皮质束和一条非丘脑对照束。提取每个束的各向异性分数（FA）、均值（MD）、轴向（AD）和径向扩散系数（RD），以反映微观结构的完整性。使用线性回归模型评估丘脑 ADC(tCr)与束指标之间的相关性，调整年龄、性别、丘脑体积、丘脑 ADC(tNAA)和束特异性病变负荷。
MS 患者较低的丘脑 ADC(tCr)与丘脑皮质投射的 MD 和 RD 升高相关（MD：=0.029；RD：=0.017），但在 HC 中无相关性（MD：=0.625，丘脑 ADC(tCr)与组间的交互项=0.019；RD：=0.320，交互项=0.05）。丘脑 ADC(tCr)与对照束的微观结构变化无关。
丘脑 ADC(tCr)降低与 MS 患者丘脑皮质束损伤相关，表明丘脑能量代谢的病理变化与连接纤维的结构退变有关。
