Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia/Sydney Neuroimaging Analysis Centre, Camperdown, NSW, Australia.
Mult Scler. 2022 Sep;28(10):1504-1514. doi: 10.1177/13524585221080667. Epub 2022 Mar 16.
Expansion of chronic lesions in multiple sclerosis (MS) patients and recently described cerebrospinal fluid (CSF)-related gradient of tissue damage are linked to microglial activation. The aim of this study was to investigate whether lesion expansion is associated with proximity to ventricular CSF spaces.
Pre- and post-gadolinium three-dimensional (3D)-T1, 3D FLAIR and diffusion tensor images were acquired from 36 relapsing-remitting MS (RRMS) patients. Lesional activity was analysed between baseline and 48 months at different distances from the CSF using successive 1 mm thick concentric bands radiating from the ventricles.
Voxel-based analysis of the rate of lesion expansion demonstrated a clear periventricular gradient decreasing away from the ventricles. This was particularly apparent when lesions of equal diameter were analysed. Periventricular lesional tissue showed higher degree of tissue destruction at baseline that significantly increased during follow-up in bands close to CSF. This longitudinal change was proportional to degree of lesion expansion. Lesion-wise analysis revealed a gradual, centrifugal decrease in the proportion of expanding lesions from the immediate periventricular zone.
Our data suggest that chronic white matter lesions in close proximity to the ventricles are more destructive, show a higher degree of expansion at the lesion border and accelerated tissue loss in the lesion core.
多发性硬化症（MS）患者的慢性病变扩张以及最近描述的与脑脊液（CSF）相关的组织损伤梯度与小胶质细胞激活有关。本研究旨在探讨病变扩张是否与靠近脑室 CSF 空间有关。
从 36 例复发缓解型多发性硬化症（RRMS）患者中采集了钆前后三维（3D）T1、3D FLAIR 和扩散张量图像。使用从脑室辐射的连续 1mm 厚同心带，在不同距离的 CSF 处分析基线和 48 个月之间的病变活动性。
病变扩张速度的体素基分析显示出明显的脑室周围梯度，随着距离的增加而逐渐减小。当分析等直径的病变时，这种情况尤为明显。脑室周围的病变组织在基线时显示出更高程度的组织破坏，在靠近 CSF 的带中在随访期间显著增加。这种纵向变化与病变扩张的程度成正比。病变分析显示，从脑室周围区域到病变核心，扩张病变的比例逐渐减小。
我们的数据表明，靠近脑室的慢性白质病变更具破坏性，在病变边界处显示出更高程度的扩张，并且在病变核心处加速组织丢失。
