Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Eur J Neurol. 2022 Jul;29(7):2036-2046. doi: 10.1111/ene.15329. Epub 2022 Apr 4.
To investigate the relationship between the functional connectivity (FC) of the sensorimotor and cognitive cerebellum and measures of structural damage in patients with multiple sclerosis (MS) and no physical disability.
We selected 144 relapsing-remitting MS patients with an Expanded Disability Status Scale score of ≤1.5 and 98 healthy controls from the Italian Neuroimaging Network Initiative database. From multimodal 3T magnetic resonance imaging (MRI), including functional MRI at rest, we calculated lesion load, cortical thickness, and white matter, cortical gray matter, and caudate, putamen, thalamic, and cerebellar volumes. Voxel-wise FC of the sensorimotor and cognitive cerebellum was assessed with seed-based analysis, and multiple regression analysis was used to evaluate the relationship between FC and structural damage.
Whole brain, white matter, caudate, putamen, and thalamic volumes were reduced in patients compared to controls, whereas cortical gray matter was not significantly different in patients versus controls. Both the sensorimotor and cognitive cerebellum showed a widespread pattern of increased and decreased FC that were negatively associated with structural measures, indicating that the lower the FC, the greater the tissue loss. Lastly, among multiple structural measures, cortical gray matter and white matter volumes were the best predictors of cerebellar FC alterations.
Increased and decreased cerebellar FC with several brain areas coexist in MS patients with no disability. Our data suggest that white matter loss hampers FC, whereas, in the absence of atrophy, cortical volume represents the framework for FC to increase.
研究无躯体残疾的多发性硬化症（MS）患者感觉运动和认知小脑的功能连接（FC）与结构损伤测量值之间的关系。
我们从意大利神经影像学网络倡议数据库中选择了 144 名扩展残疾状况量表评分≤1.5 的复发缓解型 MS 患者和 98 名健康对照者。从多模态 3T 磁共振成像（MRI），包括静息功能 MRI 中，我们计算了病变负荷、皮质厚度和白质、皮质灰质以及尾状核、壳核、丘脑和小脑体积。采用种子点分析评估感觉运动和认知小脑的全脑 FC，采用多元回归分析评估 FC 与结构损伤的关系。
与对照组相比，患者的全脑、白质、尾状核、壳核和丘脑体积减少，而皮质灰质在患者与对照组之间无显著差异。感觉运动和认知小脑均表现出广泛的 FC 增加和减少模式，与结构测量值呈负相关，这表明 FC 越低，组织损失越大。最后，在多种结构测量中，皮质灰质和白质体积是小脑 FC 改变的最佳预测指标。
无残疾 MS 患者存在伴发的小脑 FC 增加和减少，与多个脑区有关。我们的数据表明，白质丢失会阻碍 FC，而在没有萎缩的情况下，皮质体积代表 FC 增加的框架。
