Department of Neurology, 9967University of Alabama at Birmingham, Birmingham, AL, United States.
Department of Physical Therapy, 9968University of Alabama at Birmingham, Birmingham, AL, United States.
Neurorehabil Neural Repair. 2022 Apr;36(4-5):286-297. doi: 10.1177/15459683221076461. Epub 2022 Feb 14.
Older adults with multiple sclerosis (MS) experience mobility impairments, but conventional brain imaging is a poor predictor of walking abilities in this population.
To test whether brain metabolites measured with Magnetic Resonance Spectroscopy (MRS) are associated with walking performance in older adults with MS.
Fifteen older adults with MS (mean age: 60.9, SD: 5.1) and 22 age-matched healthy controls (mean age: 64.2, SD: 5.7) underwent whole-brain MRS and mobility testing. Levels of N-acetylaspartate (NAA), myo-inositol (MI), choline (CHO), and temperature in 47 brain regions were compared between groups and correlated with walking speed (Timed 25 Foot Walk) and walking endurance (Six-Minute Walk).
Older adults with MS had higher MI in 23 areas, including the bilateral frontal (right: t (21.449) = -2.605, P = .016; left: t (35) = -2.434, P = .020), temporal (right: t (35) = -3.063, P = .004; left: t (35) = -3.026, P = .005), and parietal lobes (right: t (21.100) = -2.886, P = .009; left: t (35) = -2.507, P = .017), and right thalamus (t (35) = -2.840, P = .007). MI in eleven regions correlated with walking speed, and MI in twelve regions correlated with walking endurance. NAA was lower in MS in the bilateral thalami (right: t (35) = 3.449, P < .001; left: t (35) = 2.061, P = .047), caudate nuclei (right: t (33) = 2.828, P = .008; left: t (32) = 2.132, P = .041), and posterior cingulum (right: t (35) = 3.077, P = .004; left: t (35) = 2.972, P = .005). NAA in four regions correlated with walking speed and endurance. Brain temperature was higher in MS patients in four regions, but did not correlate with mobility measures. There were no group differences in CHO.
MI and NAA may be useful imaging end-points for walking ability as a clinical outcome in older adults with MS.
多发性硬化症（MS）老年患者存在运动障碍，但常规脑部影像学检查对该人群的步行能力预测效果不佳。
测试磁共振波谱（MRS）测量的脑代谢物是否与 MS 老年患者的步行能力相关。
15 名 MS 老年患者（平均年龄：60.9，标准差：5.1）和 22 名年龄匹配的健康对照组（平均年龄：64.2，标准差：5.7）接受了全脑 MRS 和移动能力测试。比较两组之间 47 个脑区的 N-乙酰天冬氨酸（NAA）、肌醇（MI）、胆碱（CHO）和温度水平，并与步行速度（定时 25 英尺步行）和步行耐力（6 分钟步行）相关。
MS 老年患者有 23 个脑区的 MI 升高，包括双侧额叶（右侧：t (21.449) = -2.605，P =.016；左侧：t (35) = -2.434，P =.020）、颞叶（右侧：t (35) = -3.063，P =.004；左侧：t (35) = -3.026，P =.005）和顶叶（右侧：t (21.100) = -2.886，P =.009；左侧：t (35) = -2.507，P =.017）和右侧丘脑（t (35) = -2.840，P =.007）。11 个区域的 MI 与步行速度相关，12 个区域的 MI 与步行耐力相关。双侧丘脑（右侧：t (35) = 3.449，P <.001；左侧：t (35) = 2.061，P =.047）、尾状核（右侧：t (33) = 2.828，P =.008；左侧：t (32) = 2.132，P =.041）和后扣带回（右侧：t (35) = 3.077，P =.004；左侧：t (35) = 2.972，P =.005）中 MS 患者的 NAA 降低。4 个区域的 NAA 与步行速度和耐力相关。4 个脑区的脑温在 MS 患者中升高，但与移动能力测量值无相关性。CHO 两组间无差异。
MI 和 NAA 可能是 MS 老年患者步行能力的有用影像学终点。
