Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany/NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany/ Department of Experimental Neurology and Center for Stroke Research, Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany/ Einstein Center for Neurosciences, Berlin, Germany.
Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany/NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany/ Department for Psychiatry and Psychotherapy-Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Mult Scler. 2021 Dec;27(14):2180-2190. doi: 10.1177/13524585211003479. Epub 2021 Apr 15.
Cross-sectional studies suggest normal appearing white matter (NAWM) integrity loss may lead to cortical atrophy in late-stage relapsing-remitting multiple sclerosis (MS).
To investigate the relationship between NAWM integrity and cortical thickness from first clinical presentation longitudinally.
NAWM integrity and cortical thickness were assessed with 3T magnetic resonance imaging (MRI) in 102 patients with clinically isolated syndrome or early MS (33.2 (20.1-60.1) years old, 68% female) from first clinical presentation over 2.8 ± 1.6 years. Fifty healthy controls (HCs) matched for age and sex were included. NAWM integrity was evaluated using the standardized T1w/T2w ratio (sT1w/T2w). The association between sT1w/T2w and cortical thickness was assessed using linear mixed models. The effect of disease activity was investigated using the No Evidence of Disease Activity (NEDA-3) criteria.
At baseline, sT1w/T2w ( = 0.152) and cortical thickness ( = 0.489) did not differ from HCs. Longitudinally, decreasing sT1w/T2w was associated with cortical thickness and increasing lesion burden (marginal = 0.061). The association was modulated by failing NEDA-3 (marginal = 0.097).
sT1w/T2w may be a useful MRI biomarker for early MS, detecting relevant NAWM damage over time using conventional MRI scans, although with less sensitivity compared to quantitative measures.
横断面研究表明，正常表现的白质（NAWM）完整性损失可能导致复发缓解型多发性硬化症（MS）的皮质萎缩。
从首次临床发作开始，纵向研究 NAWM 完整性与皮质厚度之间的关系。
对 102 例临床孤立综合征或早期 MS 患者（33.2（20.1-60.1）岁，68%为女性）进行 3T 磁共振成像（MRI）检查，评估其首次临床发作后 2.8±1.6 年的 NAWM 完整性和皮质厚度。纳入 50 名年龄和性别匹配的健康对照（HC）。采用标准化 T1w/T2w 比值（sT1w/T2w）评估 NAWM 完整性。采用线性混合模型评估 sT1w/T2w 与皮质厚度之间的相关性。采用无疾病活动证据（NEDA-3）标准研究疾病活动的影响。
基线时，sT1w/T2w（ = 0.152）和皮质厚度（ = 0.489）与 HCs 无差异。纵向研究显示，sT1w/T2w 降低与皮质厚度和病变负荷增加相关（边际 = 0.061）。该相关性受 NEDA-3 失败的调节（边际 = 0.097）。
sT1w/T2w 可能是早期 MS 的一种有用的 MRI 生物标志物，通过常规 MRI 扫描随时间检测到相关的 NAWM 损伤，尽管与定量测量相比，其敏感性较低。
