结构 MRI 显示的数字测量的神经相关性：基于智能手机的多发性硬化远程评估可行性研究的事后分析。
Neural correlates of digital measures shown by structural MRI: a post-hoc analysis of a smartphone-based remote assessment feasibility study in multiple sclerosis.
机构信息
F. Hoffmann-La Roche Ltd, Basel, Switzerland.
Department of Neurosciences, University of California San Diego, San Diego, CA, USA.
出版信息
J Neurol. 2023 Mar;270(3):1624-1636. doi: 10.1007/s00415-022-11494-0. Epub 2022 Dec 5.
BACKGROUND
A study was undertaken to evaluate remote monitoring via smartphone sensor-based tests in people with multiple sclerosis (PwMS). This analysis aimed to explore regional neural correlates of digital measures derived from these tests.
METHODS
In a 24-week, non-randomized, interventional, feasibility study (NCT02952911), sensor-based tests on the Floodlight Proof-of-Concept app were used to assess cognition (smartphone-based electronic Symbol Digit Modalities Test), upper extremity function (Draw a Shape Test, Pinching Test), and gait and balance (Static Balance Test, Two-Minute Walk Test, U-Turn Test). In this post-hoc analysis, digital measures and standard clinical measures (e.g., Nine-Hole Peg Test [9HPT]) were correlated against regional structural magnetic resonance imaging outcomes. Seventy-six PwMS aged 18-55 years with an Expanded Disability Status Scale score of 0.0-5.5 were enrolled from two different sites (USA and Spain). Sixty-two PwMS were included in this analysis.
RESULTS
Worse performance on digital and clinical measures was associated with smaller regional brain volumes and larger ventricular volumes. Whereas digital and clinical measures had many neural correlates in common (e.g., putamen, globus pallidus, caudate nucleus, lateral occipital cortex), some were observed only for digital measures. For example, Draw a Shape Test and Pinching Test measures, but not 9HPT score, correlated with volume of the hippocampus (r = 0.37 [drawing accuracy over time on the Draw a Shape Test]/ - 0.45 [touching asynchrony on the Pinching Test]), thalamus (r = 0.38/ - 0.41), and pons (r = 0.35/ - 0.35).
CONCLUSIONS
Multiple neural correlates were identified for the digital measures in a cohort of people with early MS. Digital measures showed associations with brain regions that clinical measures were unable to demonstrate, thus providing potential novel information on functional ability compared with standard clinical assessments.
背景
本研究旨在评估基于智能手机传感器的远程监测在多发性硬化症患者（PwMS）中的应用。本分析旨在探索这些测试得出的数字指标的区域神经相关性。
方法
在一项 24 周、非随机、干预性、可行性研究（NCT02952911）中，使用 Floodlight 概念验证应用程序上的基于传感器的测试来评估认知（基于智能手机的电子符号数字模态测试）、上肢功能（绘图测试、捏合测试）以及步态和平衡（静态平衡测试、两分钟步行测试、U 型转弯测试）。在这项事后分析中，数字指标和标准临床指标（如 9 孔钉测试[9HPT]）与区域结构磁共振成像结果相关。共招募了来自两个不同地点（美国和西班牙）的 76 名年龄在 18-55 岁、扩展残疾状况量表评分为 0.0-5.5 的 PwMS。共有 62 名 PwMS 纳入了此项分析。
结果
数字和临床指标的表现越差，与大脑区域体积越小和脑室体积越大相关。虽然数字和临床指标有许多共同的神经相关性（例如，壳核、苍白球、尾状核、外侧枕叶皮质），但有些只与数字指标相关。例如，绘图测试和捏合测试的测量值，但不是 9HPT 评分，与海马体体积（r=0.37[绘图测试中随时间推移的绘图准确性]/-0.45[捏合测试中的触诊不同步]）、丘脑（r=0.38/-0.41）和脑桥（r=0.35/-0.35）相关。
结论
在早期多发性硬化症患者队列中，确定了多个与数字指标相关的神经相关性。数字指标与临床指标无法显示的大脑区域相关，因此与标准临床评估相比，为功能能力提供了潜在的新信息。
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