Save Sight Institute, Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia.
Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia/Sydney Neuroimaging Analysis Centre, Camperdown, NSW, Australia.
Mult Scler. 2022 Nov;28(13):2038-2045. doi: 10.1177/13524585221111684. Epub 2022 Jul 21.
Change in ventricular volume has been suggested as surrogate measure of central brain atrophy (CBA) applicable to the everyday management of multiple sclerosis (MS) patients.
We investigated the contribution of inflammatory activity (including the severity of lesional tissue damage) to CBA.
Fifty patients with relapsing-remitting multiple sclerosis (RRMS) were enrolled. Lesional activity during 4 years of follow-up was analysed using custom-build software, which segmented expanding part of the chronic lesions, new confluent lesions and new free-standing lesions. The degree of lesional tissue damage was assessed by change in mean diffusivity (MD). Volumetric change of lateral ventricles was used to measure CBA.
During follow-up, ventricles expanded on average by 12.6% ± 13.7% (mean ± ). There was a significant increase of total lesion volume, 69.3% of which was due to expansion of chronic lesions. Correlation between volume of combined lesional activity and CBA ( = 0.67) increased when lesion volume was adjusted by the degree of tissue damage severity ( = 0.81). Regression analysis explained 90% of CBA variability, revealing that chronic lesion expansion was by far the largest contributor to ventricular enlargement.
CBA is almost entirely explained by the combination of the volume and severity of lesional activity. The expansion of chronic lesions plays a central role in this process.
心室容积的变化已被认为是中枢性脑萎缩（CBA）的替代指标，适用于多发性硬化症（MS）患者的日常管理。
我们研究了炎症活动（包括病变组织损伤的严重程度）对 CBA 的贡献。
共纳入 50 例复发缓解型多发性硬化症（RRMS）患者。使用定制软件分析 4 年随访期间的病变活动，该软件可对扩展的慢性病变部分、新融合性病变和新孤立性病变进行分割。通过平均弥散度（MD）的变化评估病变组织损伤的程度。用侧脑室的体积变化来衡量 CBA。
在随访期间，脑室平均扩张了 12.6%±13.7%（平均值±）。总的病变体积显著增加，其中 69.3%是由于慢性病变的扩张。联合病变活动的体积与 CBA 之间存在显著相关性（ = 0.67），当病变体积通过组织损伤严重程度进行调整时，相关性增加到 0.81。回归分析解释了 CBA 变异性的 90%，表明慢性病变的扩张是脑室扩大的主要原因。
CBA 几乎完全由病变活动的体积和严重程度来解释。慢性病变的扩张在这个过程中起着核心作用。
