The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy (MIRT), Bushehr Medical University Hospital, Bushehr University of Medical Sciences, Bushehr, Iran.
Department of Neurology, Bushehr Medical University Hospital, Bushehr University of Medical Sciences, Bushehr, Iran.
Br J Radiol. 2021 Nov 1;94(1127):20210308. doi: 10.1259/bjr.20210308. Epub 2021 Sep 7.
There is increasing evidence that gray matter (GM) impairment is strongly associated with clinical performance decline. We aim to perform a voxelwise analysis between regional GM (rGM) perfusion and structural abnormalities in early relapsing-remitting multiple sclerosis patients with normal cognition (RRMS-IC) and explore clinical correlate of early rGM abnormalities.
We studied 14 early RRMS-IC patients and 14 healthy age- and sex-matched controls. Brain perfusion single photon emission computed tomography (SPECT), structural MRI, and a comprehensive neuropsychological examination were acquired from all participants. Neuropsychological tests include expanded disability status scale, minimal mental status examination, short physical performance battery, Wechsler memory scale, and quick smell test. Voxel-based morphometry was used for analyzing SPECT and T1-MR images to identify rGM hypoperfusion and atrophy, respectively (RRMS-IC controls (group analysis), and also, each patient controls (individual analysis)) ( < 0.001). Then, anatomical location of impaired regions was acquired by automated anatomical labeling software.
There was no significant difference in total GM volume between RRMS-IC and healthy controls, however, rGM atrophy and hypoperfusion were detected. Individual analysis revealed more rGM impairment compared with group analysis. rGM hypoperfusion was more extensive rather than rGM atrophy in RRMS-IC. There was no spatial association between rGM atrophy and rGM hypoperfusion ( > 0.05). rGM abnormalities correlated with several relevant minimal clinical deficits.
Lack of spatial correlation between rGM atrophy and hypoperfusion might suggest that independent mechanisms might underlie atrophy and hypoperfusion. Perfusion SPECT may provide supplementary information along with MRI.
Association between rGM atrophy and rGM hypoperfusion and their clinical significance in early RRMS-IC is not well described yet. Our study showed that there is spatial dissociation between rGM atrophy and rGM hypoperfusion, suggesting that different mechanisms might underlie these pathologies.
越来越多的证据表明，灰质（GM）损伤与临床表现下降密切相关。我们旨在对认知正常的早期复发缓解型多发性硬化症患者（RRMS-IC）进行区域 GM（rGM）灌注与结构异常的体素分析，并探讨早期 rGM 异常的临床相关性。
我们研究了 14 例早期 RRMS-IC 患者和 14 例年龄和性别匹配的健康对照者。所有参与者均接受了脑灌注单光子发射计算机断层扫描（SPECT）、结构磁共振成像（MRI）和全面的神经心理学检查。神经心理学测试包括扩展残疾状态量表、最小精神状态检查、简短体能测试、韦氏记忆量表和快速嗅觉测试。体素形态计量学用于分析 SPECT 和 T1-MR 图像，以分别识别 rGM 低灌注和萎缩（RRMS-IC 对照（组分析），并且，每位患者 对照（个体分析））（ < 0.001）。然后，通过自动解剖学标记软件获取受损区域的解剖位置。
RRMS-IC 与健康对照组之间的总 GM 体积无显著差异，但检测到 rGM 萎缩和低灌注。个体分析显示 rGM 损伤比组分析更为广泛。RRMS-IC 中 rGM 低灌注比 rGM 萎缩更为广泛。rGM 萎缩和 rGM 低灌注之间没有空间关联（ > 0.05）。rGM 异常与几个相关的最小临床缺陷相关。
rGM 萎缩和低灌注之间缺乏空间相关性可能表明，萎缩和低灌注可能由不同的机制引起。灌注 SPECT 可能会与 MRI 一起提供补充信息。
rGM 萎缩和 rGM 低灌注之间的相关性及其在早期 RRMS-IC 中的临床意义尚未得到很好的描述。我们的研究表明，rGM 萎缩和 rGM 低灌注之间存在空间分离，这表明这些病理可能由不同的机制引起。
