Department of Traditional Chinese Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
School of Management Science and Engineering, Shandong University of Finance and Economics, Jinan, China.
Clin Neurol Neurosurg. 2021 Aug;207:106805. doi: 10.1016/j.clineuro.2021.106805. Epub 2021 Jul 10.
Multiple sclerosis (MS) is a demyelinating disease of the central nervous system, predominating within young adults. Cognitive disorders are common in MS and have are associated with several Magnetic Resonance Imaging (MRI) markers, especially brain atrophy. Many have found the symbol digit modalities test (SDMT) to be the most sensitive individual cognitive measure relevant to MS. However, the relationship between SDMT and regional brain cortex thickness in young adults with relapsing-remitting multiple sclerosis (YA-RRMS) has been little explored. The purpose of this study was to investigate the association between the SDMT and regional cortex thickness in YA-RRMS by FreeSurfer, which is an automatic brain structure segmentation method.
Twenty-eight YA-RRMS patients (18-35 years old) were enrolled in the present study. Informed consent and information including gender, age, disease duration, number of relapses, annual relapse rate was collected from all patients. Clinical cognitive evaluations (SDMT and auditory verbal learning test (AVLT)) and daily performance: activities of daily living (ADL) were assessed in the present study. MRI scans were performed at the Institute of Neurosurgery of Tiantan Hospital. Twenty-eight matched healthy controls (HC) MRI data were obtained from Tiantan Hospital database. Data on thirty-four points of bilateral cortical structure thickness using statistically defined brain regions-of-interest from FreeSurfer were obtained from all participants.
Patients with RRMS exhibited extensively thinner cerebellar cortex compared with HC. SDMT scores were significantly correlated with AVLT subentries (IM, immediate memory; DRM, delayed recall memory; LTRM, long-term recognition memory) in YA-RRMS patients (P < 0.05). SDMT was strongly correlated with regional cortex thickness differences of the right temporal pole (r = 0.68) and bilateral parahippocampal areas (right r = 0.62; left r = 0.60), and moderately correlated with regional cortex thickness differences including the left superior temporal and right insula (r = 0.57 and 0.56, respectively) in YA-RRMS patients.
The present study has shown the SDMT is strongly correlated with selected cortex regions including the bilateral parahippocampal area and the right temporal pole which are involved in geometric structures processing.
多发性硬化症（MS）是一种中枢神经系统脱髓鞘疾病，主要发生在年轻人中。认知障碍在 MS 中很常见，与多个磁共振成像（MRI）标志物相关，尤其是脑萎缩。许多人发现符号数字模式测试（SDMT）是与 MS 最相关的个体认知测量的最敏感指标。然而，复发缓解型多发性硬化症（YA-RRMS）年轻患者的 SDMT 与大脑皮质区域厚度之间的关系尚未得到充分探索。本研究旨在通过 FreeSurfer 研究 YA-RRMS 患者的 SDMT 与大脑皮质区域厚度之间的关系，FreeSurfer 是一种自动脑结构分割方法。
本研究纳入了 28 例 YA-RRMS 患者（18-35 岁）。从所有患者中收集了性别、年龄、疾病持续时间、复发次数、年复发率等信息，并获得了知情同意。本研究评估了临床认知评估（SDMT 和听觉词语学习测试（AVLT））和日常表现：日常生活活动（ADL）。在天坛医院神经外科研究所进行了 MRI 扫描。从天坛医院数据库中获得了 28 例匹配的健康对照（HC）MRI 数据。使用 FreeSurfer 中定义的统计大脑区域的 34 个双侧皮质结构厚度数据点从所有参与者中获得。
RRMS 患者的小脑皮质明显变薄与 HC 相比。SDMT 评分与 YA-RRMS 患者的 AVLT 亚项（IM，即时记忆；DRM，延迟回忆记忆；LTRM，长期识别记忆）显著相关（P<0.05）。SDMT 与右侧颞极（r=0.68）和双侧海马旁回区域（右侧 r=0.62；左侧 r=0.60）的皮质区域厚度差异呈强相关，与左侧颞上回和右侧岛叶的皮质区域厚度差异呈中度相关（分别为 r=0.57 和 0.56）在 YA-RRMS 患者中。
本研究表明，SDMT 与包括双侧海马旁回和右侧颞极在内的选定皮质区域强烈相关，这些区域涉及几何结构处理。
