Department of Adult Neurology, Medical University of Gdańsk, Faculty of Medicine, Gdańsk, Poland.
2nd Department of Radiology, Medical University of Gdańsk, Faculty of Medicine, Gdańsk, Poland.
Brain Behav. 2022 Jun;12(6):e2591. doi: 10.1002/brb3.2591. Epub 2022 May 13.
Peak width of Skeletonized Mean Diffusivity (PSMD), as a novel marker of white matter (WM) microstructure damage, is associated with cognitive decline in several WM pathologies (i.e., small vessel disorders). We hypothesized that markers combining alterations in whole WM could be associated with cognitive dysfunction in relapsing-remitting multiple sclerosis (RRMS) patients.
We used PSMD based on tract-based spatial statistics (TBSS) of diffusion tensor imaging (DTI) magnetic resonance (MR) scans. We investigated RRMS patients (n = 73) undergoing interferon beta (IFN-β) therapy. In this cross-sectional study, we investigated the association between neuropsychological data and clinical and MRI variables: PSMD, WM hypointensities, and normalized brain volume (NBV).
In our cohort, 37 (50.7%) patients were recognized as cognitively impaired (CI) and 36 (49.3%) patients were cognitively normal (CN). In regression analysis, PSMD was a statistically significant contributor in the California Verbal Learning Test (CVLT) list A (p = 0.04) and semantic fluency (p = 0.036). PSMD (p < 0.001, r = 0.35), NBV (p = 0.002, r = 2.6) and WM hypointensities (p < 0.001, r = 0.40) were major contributors to upper extremity disability (9HPT) in the CN subgroup. A significant contributor in the majority of neuropsychological measures was education attainment.
We investigated PSMD as a new parameter of WM microstructure damage that is a contributor in complex cognitive tasks, CVLT performance, and semantic fluency. PSMD was a statistically significant contributor to upper extremity disability (9HPT) together with WM hypointensities and NBV. Education attainment proved to be relevant in the majority of cognitive domains. Further studies are needed to estimate PSMD relevance as a marker of CI in MS.
骨架平均峰度弥散度（PSMD）作为一种新的白质（WM）微观结构损伤标志物，与几种 WM 病变（即小血管疾病）的认知能力下降有关。我们假设，综合整个 WM 改变的标志物可能与复发缓解型多发性硬化症（RRMS）患者的认知功能障碍有关。
我们使用基于扩散张量成像（DTI）磁共振（MR）扫描的基于束流的空间统计学（TBSS）的 PSMD。我们对正在接受干扰素-β（IFN-β）治疗的 RRMS 患者（n=73）进行了研究。在这项横断面研究中，我们研究了神经心理学数据与临床和 MRI 变量之间的关系：PSMD、WM 低信号强度和正常化脑容量（NBV）。
在我们的队列中，37 名（50.7%）患者被认为认知受损（CI），36 名（49.3%）患者认知正常（CN）。在回归分析中，PSMD 在加利福尼亚语言学习测试（CVLT）列表 A（p=0.04）和语义流畅性（p=0.036）中是一个具有统计学意义的贡献者。PSMD（p<0.001，r=0.35）、NBV（p=0.002，r=2.6）和 WM 低信号强度（p<0.001，r=0.40）是 CN 亚组的 9 小时体力测试（9HPT）上肢残疾的主要贡献者。受教育程度是大多数神经心理学测试的重要贡献者。
我们研究了 PSMD 作为 WM 微观结构损伤的新参数，它是复杂认知任务、CVLT 表现和语义流畅性的一个贡献者。PSMD 是 9 小时体力测试（9HPT）上肢残疾的一个具有统计学意义的贡献者，与 WM 低信号强度和 NBV 一起。受教育程度在大多数认知领域都很重要。需要进一步的研究来评估 PSMD 作为 MS 认知障碍标志物的相关性。
