髓鞘成像测量作为 MS 患者认知障碍的预测指标：一项 PET-MRI 联合研究。
Myelin imaging measures as predictors of cognitive impairment in MS patients: A hybrid PET-MRI study.
机构信息
Laboratory of Nuclear Medicine (LIM43), Department of Radiology and Oncology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil; Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
Department of Radiology and Oncology Institute, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
出版信息
Mult Scler Relat Disord. 2022 Jan;57:103331. doi: 10.1016/j.msard.2021.103331. Epub 2021 Oct 13.
BACKGROUND
Cognitive impairment is one of the concerns of Multiple Sclerosis (MS) and has been related to myelin loss. Different neuroimaging methods have been used to quantify myelin and relate it to cognitive dysfunctions, among them Magnetization Transfer Ratio (MTR), Diffusion Tensor Imaging (DTI), and, more recently, Positron Emission Tomography (PET) with C-PIB.
OBJECTIVE
To investigate different myelin imaging modalities as predictors of cognitive dysfunction.
METHODS
Fifty-one MS patients and 24 healthy controls underwent clinical and neuropsychological assessment and MTR, DTI (Axial Diffusion-AD and Fractional Anisotropy-FA maps), and C-PIB PET images in a PET/MR hybrid system.
RESULTS
MTR and DTI(FA) differed in patients with or without cognitive impairment. There was an association of DTI(FA) and DTI(AD) with cognition and psychomotor speed for progressive MS, and of C-PIB uptake and MTR for relapsing-remitting MS. MTR in the Thalamus (β= -0.51, p = 0.021) and Corpus Callosum (β= -0.24, p = 0.033) were predictive of cognitive impairment. DTI-FA in the Caudate (β= -26.93, p = 0.006) presented abnormal predictive result.
CONCLUSION
Lower myelin content by C-PIB uptake was associated with worse cognitive status. MTR was predictive of cognitive impairment in MS.
背景
认知障碍是多发性硬化症（MS）的关注点之一，与髓鞘丢失有关。已经使用了不同的神经影像学方法来量化髓鞘并将其与认知功能障碍相关联，其中包括磁化传递率（MTR）、弥散张量成像（DTI），以及最近的正电子发射断层扫描（PET）与 C-PIB。
目的
研究不同的髓鞘成像方式作为认知功能障碍的预测因子。
方法
51 名 MS 患者和 24 名健康对照者接受了临床和神经心理学评估以及 MTR、DTI（轴向弥散-AD 和分数各向异性-FA 图）和 C-PIB PET 图像在 PET/MR 混合系统中。
结果
MTR 和 DTI（FA）在有或没有认知障碍的患者中有所不同。在进展性 MS 中，DTI（FA）和 DTI（AD）与认知和运动速度有关，而在复发缓解性 MS 中，C-PIB 摄取和 MTR 与认知有关。丘脑（β= -0.51，p=0.021）和胼胝体（β= -0.24，p=0.033）的 MTR 是认知障碍的预测指标。尾状核（β= -26.93，p=0.006）的 DTI-FA 表现出异常的预测结果。
结论
C-PIB 摄取的髓鞘含量越低，认知状态越差。MTR 可预测 MS 患者的认知障碍。
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