Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada/Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.
Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada/Division of Neuroradiology, Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Mult Scler. 2021 Dec;27(14):2199-2208. doi: 10.1177/13524585211002097. Epub 2021 Mar 23.
The central vein sign (CVS) and "paramagnetic rim lesions" (PRL) are emerging imaging biomarkers in multiple sclerosis (MS) reflecting perivenular demyelination and chronic, smoldering inflammation. The objective of this study was to assess relationships between cognitive impairment (CI) and the CVS and PRL in radiologically isolated syndrome (RIS).
Twenty-seven adults with RIS underwent 3.0 T MRI of the brain and cervical spinal cord (SC) and cognitive assessment using the minimal assessment of cognitive function in MS battery. The CVS and PRL were assessed in white-matter lesions (WMLs) on T2*-weighted segmented echo-planar magnitude and phase images. Multivariable linear regression evaluated relationships between CI and MRI measures.
Global CI was present in 9 (33%) participants with processing speed and visual memory most frequently affected. Most participants (93%) had ⩾ 40% CVS + WML (a threshold distinguishing MS from other WM disorders); 63% demonstrated PRL. Linear regression revealed that CVS + WML predicted performance on verbal memory( =-0.024, = 0.03) while PRL predicted performance on verbal memory ( = -0.040, = 0.04) and processing speed ( = -0.039, = 0.03).
CI is common in RIS and is associated with markers of perivenular demyelination and chronic inflammation in WML, such as CVS + WML and PRL. A prospective follow-up of this cohort will ascertain the importance of CI, CVS, and PRL as risk factors for conversion from RIS to MS.
中央静脉征（CVS）和“顺磁性边缘病变”（PRL）是多发性硬化症（MS）中新兴的影像学生物标志物，反映了血管周围脱髓鞘和慢性、潜伏性炎症。本研究的目的是评估在影像学孤立综合征（RIS）中认知障碍（CI）与 CVS 和 PRL 之间的关系。
27 名成人 RIS 患者接受了 3.0T 脑部和颈脊髓（SC）磁共振成像（MRI）以及使用 MS 最小认知功能评估（MACFIMS）进行认知评估。在 T2*-加权分段回波平面幅度和相位图像上的白质病变（WML）中评估 CVS 和 PRL。多变量线性回归评估 CI 与 MRI 测量之间的关系。
9 名（33%）参与者存在整体 CI，其中以处理速度和视觉记忆障碍最常见。大多数参与者（93%）有 ⩾ 40%的 CVS+WML（区分 MS 与其他 WM 障碍的阈值）；63%表现出 PRL。线性回归显示 CVS+WML 预测了言语记忆的表现（ =-0.024， = 0.03），而 PRL 预测了言语记忆（ =-0.040， = 0.04）和处理速度（ =-0.039， = 0.03）的表现。
CI 在 RIS 中很常见，与 WML 中的血管周围脱髓鞘和慢性炎症标志物（如 CVS+WML 和 PRL）相关。对该队列的前瞻性随访将确定 CI、CVS 和 PRL 作为从 RIS 转化为 MS 的风险因素的重要性。
