Li Hi Shing Stacey, Lope Jasmin, McKenna Mary Clare, Chipika Rangariroyashe H, Hardiman Orla, Bede Peter
Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland.
Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland.
J Neurol Sci. 2021 May 15;424:117361. doi: 10.1016/j.jns.2021.117361. Epub 2021 Feb 21.
Post-polio syndrome (PPS) has been traditionally considered a slowly progressive condition that affects poliomyelitis survivors decades after their initial infection. Cerebral changes in poliomyelitis survivors are poorly characterised and the few existing studies are strikingly conflicting.
The overarching aim of this study is the comprehensive characterisation of cerebral grey and white matter alterations in poliomyelitis survivors with reference to healthy- and disease-controls using quantitative imaging metrics.
Thirty-six poliomyelitis survivors, 88 patients with ALS and 117 healthy individuals were recruited in a prospective, single-centre neuroimaging study using uniform MRI acquisition parameters. All participants underwent standardised clinical assessments, T1-weighted structural and diffusion tensor imaging. Whole-brain and region-of-interest morphometric analyses were undertaken to evaluate patterns of grey matter changes. Tract-based spatial statistics were performed to evaluate diffusivity alterations in a study-specific whiter matter skeleton.
In contrast to healthy controls, poliomyelitis survivors exhibited increased grey matter partial volumes in the brainstem, cerebellum and occipital lobe, accompanied by increased FA in the corticospinal tracts, cerebellum, bilateral mesial temporal lobes and inferior frontal tracts. Polio survivors exhibited increased integrity metrics in the same anatomical regions where ALS patients showed degenerative changes.
Our findings indicate considerable cortical and white matter reorganisation in poliomyelitis survivors which may be interpreted as compensatory, adaptive change in response to severe lower motor neuron injury in infancy.
脊髓灰质炎后综合征（PPS）传统上被认为是一种缓慢进展的疾病，会在初次感染数十年后影响脊髓灰质炎幸存者。脊髓灰质炎幸存者的脑部变化特征尚不明确，现有的少数研究结果存在显著冲突。
本研究的总体目标是使用定量成像指标，全面描述脊髓灰质炎幸存者脑灰质和白质的改变，并与健康对照和疾病对照进行比较。
在一项前瞻性单中心神经影像学研究中，招募了36名脊髓灰质炎幸存者、88名肌萎缩侧索硬化症（ALS）患者和117名健康个体，采用统一的MRI采集参数。所有参与者均接受标准化临床评估、T1加权结构成像和扩散张量成像。进行全脑和感兴趣区域的形态计量分析，以评估灰质变化模式。采用基于纤维束的空间统计学方法，在特定研究的白质骨架中评估扩散率改变。
与健康对照相比，脊髓灰质炎幸存者脑干、小脑和枕叶的灰质部分体积增加，同时皮质脊髓束、小脑、双侧颞叶内侧和额下回的FA值增加。脊髓灰质炎幸存者在与ALS患者出现退行性变化相同的解剖区域，表现出完整性指标增加。
我们的研究结果表明，脊髓灰质炎幸存者存在大量皮质和白质重组，这可能被解释为对婴儿期严重下运动神经元损伤的一种代偿性、适应性变化。
