皮质厚度和血清 NfL 可解释多发性硬化症新诊断患者的认知功能障碍。
Cortical Thickness and Serum NfL Explain Cognitive Dysfunction in Newly Diagnosed Patients With Multiple Sclerosis.
机构信息
From the Institute of Biomedical Research and Innovation of Cadiz (INiBICA) (A.J.C.-G., L.F., E.L.-S., F.C.-C., F.S., R.R.-L., J.D.G.R., R.E.-R., J.J.G.-R.), Cadiz, Spain; Psychology Department (A.J.C.-G., E.L.-S., F.S., J.D.G.R., J.J.G.-R.), University of Cadiz, Spain; Neurology Department (L.F., R.R.-L., R.E.-R.), Puerta del Mar University Hospital, Cadiz, Spain; and Radiodiagnostic Department (J.P.-E.), Puerta del Mar Hospital, Cadiz, Spain.
出版信息
Neurol Neuroimmunol Neuroinflamm. 2021 Aug 31;8(6). doi: 10.1212/NXI.0000000000001074. Print 2021 Nov.
BACKGROUND AND OBJECTIVES
To determine the relative importance of global or regional MRI and blood markers of neurodegeneration and neuroaxonal injury in predicting cognitive performance for recently diagnosed patients with multiple sclerosis (MS).
METHODS
Thirty-five newly diagnosed patients with relapsing-remitting MS (RRMS) and 23 healthy controls (HCs) simultaneously completed a full clinical and neuropsychological assessment, structural brain MRI, and serum neurofilament light chain (sNfL) level test. Linear regression analyses were performed to determine which global or regional measures of gray matter (GM) atrophy and cortical thickness (CT), in combination with sNfL levels and clinical scores, are most strongly related to neuropsychological impairment.
RESULTS
Compared with HCs, patients with MS showed bilateral thalamic GM atrophy (left, = 0.033; right, = 0.047) and diminished CT, particularly in the right superior and transverse temporal gyri ( = 0.045; = 0.037). Regional atrophy failed to add predictive variance, whereas anxiety symptoms, sNfL, and global CT were the best predictors (R = 0.404; < 0.001) of cognitive outcomes, with temporal thickness accounting for greater variance in cognitive deficits than global CT.
DISCUSSION
Thalamic GM atrophy and thinning in temporal regions represent a distinctive MRI trait in the early stages of MS. Although sNfL levels alone do not clearly differentiate HCs and patients with RRMS, in combination with global and regional CT, sNfL levels can better explain the presence of underlying cognitive deficits. Hence, cortical thinning and sNfL increases can be considered 2 parallel neurodegenerative markers in the pathogenesis of progression in newly diagnosed patients with MS.
背景与目的
旨在确定全局或区域性磁共振成像（MRI）与神经退行性变和神经轴突损伤的血液标志物在预测近期诊断为多发性硬化症（MS）患者认知表现方面的相对重要性。
方法
35 例新发复发缓解型多发性硬化症（RRMS）患者和 23 例健康对照者（HCs）同时完成了全面的临床和神经心理学评估、结构性脑 MRI 和血清神经丝轻链（sNfL）水平检测。进行线性回归分析，以确定哪些全局或区域性灰质（GM）萎缩和皮质厚度（CT）指标，与 sNfL 水平和临床评分相结合，与神经心理学损伤相关性最强。
结果
与 HCs 相比，MS 患者双侧丘脑 GM 萎缩（左侧， = 0.033；右侧， = 0.047）和 CT 减少，尤其是右侧优势和横向颞回（ = 0.045； = 0.037）。区域性萎缩未能增加预测方差，而焦虑症状、sNfL 和全局 CT 是认知结果的最佳预测因子（R = 0.404； < 0.001），颞部厚度比全局 CT 更能解释认知缺陷的差异。
讨论
丘脑 GM 萎缩和颞部区域变薄是 MS 早期的独特 MRI 特征。尽管 sNfL 水平本身并不能明确区分 HCs 和 RRMS 患者，但与全局和区域性 CT 相结合，sNfL 水平可以更好地解释潜在认知缺陷的存在。因此，皮质变薄和 sNfL 增加可被视为新诊断 MS 患者疾病进展过程中的 2 个平行神经退行性标志物。
Zotero 插件