脱联在多发性硬化症致残中的作用。
The role of disconnection in explaining disability in multiple sclerosis.
机构信息
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.
IRRCS Ospedale Policlinico San Martino, Largo P. Daneo, 3, 16132, Genoa, Italy.
出版信息
Eur Radiol Exp. 2022 Jun 8;6(1):23. doi: 10.1186/s41747-022-00277-x.
BACKGROUND
In multiple sclerosis, the correlation between white matter lesion volumes (LV) and expanded disability status scale (EDSS) is at best moderate, leading to the "clinico-radiological paradox", influenced by many factors, including the lack of information on the spatial localisation of each lesion on synthetic metrics such as LV. We used a probabilistic approach to provide the volume of WM tracts that may be disconnected by lesions and to evaluate its correlation with EDSS.
METHODS
Forty-five patients (aged 37.4 ± 6.8 years, mean ± standard deviation; 30 females; 29 relapsing-remitting, 16 progressive) underwent 3-T magnetic resonance imaging. Both LV and the volume of the tracts crossing the lesioned regions (disconnectome volume, DV) were calculated using BCBtoolkit and correlated with EDSS.
RESULTS
T1-weighted LV and DV significantly correlated with EDSS (p ≤ 0.006 r ≥ 0.413) as it was for T2-weighted LV and T2-weighted DV (p ≤ 0.004 r ≥ 0.430), but only T1-weighetd and T2-weighted DVs were EDSS significant predictors (p ≤ 0.001). The correlations of T1-weighted and T2-weighted LV with EDSS were significantly mediated by DV, while no effect of LV on the EDSS-DV correlation was observed.
CONCLUSION
The volume of disconnected WM bundles mediates the LV-EDSS correlation, representing the lonely EDSS predictor.
背景
在多发性硬化症中，白质病变体积（LV）与扩展残疾状况量表（EDSS）之间的相关性最多也只是中等程度，这导致了“临床-放射学悖论”，受许多因素影响，包括缺乏有关病变部位在 LV 等综合指标上的空间定位的信息。我们使用概率方法来提供可能因病变而断开的 WM 束的体积，并评估其与 EDSS 的相关性。
方法
45 名患者（年龄 37.4 ± 6.8 岁，平均值 ± 标准差；30 名女性；29 名复发缓解型，16 名进展型）接受了 3T 磁共振成像检查。使用 BCBtoolkit 计算 LV 和穿过病变区域的束的体积（断开连接体积，DV），并将其与 EDSS 相关联。
结果
T1 加权 LV 和 DV 与 EDSS 显著相关（p≤0.006，r≥0.413），T2 加权 LV 和 T2 加权 DV 也是如此（p≤0.004，r≥0.430），但只有 T1 加权和 T2 加权 DVs 是 EDSS 的显著预测因子（p≤0.001）。T1 加权和 T2 加权 LV 与 EDSS 的相关性均由 DV 介导，而 LV 对 EDSS-DV 相关性没有影响。
结论
断开的 WM 束的体积介导了 LV-EDSS 相关性，代表了 EDSS 的唯一预测因子。
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